I have slipped.

Yes, I believe I’ve slipped into a state that can only be described as auto-pilot. A state that moves with perfect order, with no one living inside it.

And nothing is slipping away from me.

I rise precisely when the hour demands it. The day unfolds in its appointed segments. Cases are assessed, decisions are rendered with the cold clarity of a surgeon’s knife, and dispositions occur without the slightest hitch or residue of hesitation.

From the outside, it must appear a model of human competence.

And yet… and yet, here is the tormenting paradox, gnawing at me like a vulture methodically stripping a carcass to the bone:

I am no longer inside this life of mine.

Case after case, obligation after obligation, each yielding seamlessly to the following one, like beads on an endless rosary.

I once congratulated myself on this very cleanliness.

“To carry nothing forward,” I thought in my former arrogance, “to shed each burden the instant its purpose is served; that is the mark of a superior soul.”

But now, in these quieter, more merciless hours of self-examination, I ask myself:

What exactly is being carried at all?

Is there even a soul left to travel?

Or has the traveller long since stepped off the train, leaving only the rattling carriage to continue along the tracks?

The affliction does not confine itself to the ER. It spreads like a subtle poison into every corner of my existence.

One laughs at the appropriate jest, nods at the expected wisdom, agrees or disagrees with the measured tone that society demands.

Only later, when the room has emptied and the echoes have died against the walls, does the terrible emptiness reveal itself.

Nothing remains.

There’s no aftertaste, lingering warmth or sting. Not even a fragment that one might turn over in the hand and say, “this was mine; this touched me.”

It’s as if I’ve become a mere spectator to my own existence, seated in the cheap seats of a dimly lit theater, watching an actor who has meticulously studied my every gesture to the point where I’m almost convinced.

The performance is flawless.

But the man watching knows the truth:

the actor is not me.

I’m elsewhere. Somewhere colder.

And here lies the peculiar treachery of this condition:

there’s no resistance.

That is what makes continuing so incredibly effortless.

I don’t receive any urgent calls from the depths of my soul demanding a change of direction.

I simply proceed.

The train glides through familiar countryside, the landscape gradually dissolving into a monotonous ribbon of grey and green.

I think to myself, “At least nothing hurts.”

I find myself waiting, like a condemned man in his prison, for some interruption.

I don’t pray for lightning to strike the rails or for the bridge to collapse beneath me.

A mere crack would suffice.

A single moment when the mechanism falters and the true “I” is forced back into the driver’s seat, hands gripping the wheel with the old, trembling urgency of choice.

A moment that declares:

“This direction, you chose it. Will you now choose another?”

But no such moment arrives.

The days continue their smooth, courteous procession.

Nothing is broken enough to warrant halting the machine, and nothing feels alive enough to make one desperate to remain aboard.

I torment myself with the question of origins.

When exactly did this slippage begin?

Was it gradual, like the slow encroachment of monsoon dampness into the walls of an old building, invisible until the plaster begins to crumble?

Or was there a precise instant, a decision taken too lightly, a compromise accepted with too little protest after which the pilot quietly excused himself and left the controls unmanned?

I cannot say.

Memory itself has become unreliable in this state; events blur together, stripped of their color, like old photographs left too long in the sun.

Nor do I know how this ends.

Will some external shock, say one day the body rebels, or a relationship breaks, or the carefully balanced part of professional life trembles - jolt the mechanism back into painful, conscious life?

Or will I simply glide onward, year after year, until the final station arrives and I step off without ever having truly ridden?

What I know with a certainty that borders on fever is this:

Lately, my life runs with an eerie, almost supernatural perfection. Almost without me.

And in the silence that follows such a realization, a deeper question rises, terrible in its simplicity:

If I am not the one living this life, then who or what is?

And more frightening still:

If I were to seize the controls again, would anything answer?

Or have I already crossed some quiet, inevitable threshold,

beyond which there is no return,

no recovery of the man who once felt, chose and suffered.

Only this efficient, obedient thing

that wakes, works, speaks and sleeps,

while something essential lies behind it,

unattended,

and quietly rotting.

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More soon.

Another moment.

Another reminder that we are still, somehow, human in all of this.

Yours,

Adarsh Nath,

Letters from the ER