The woman going up in the medical building elevator with me was so young and beautiful and carefree that it took my breath away. Young and beautiful is not so unusual in Beverly Hills. But carefree?

I looked to see if she was carrying a case — a sure sign of a drug company representative — but she wasn't. I half followed her, looking to see if maybe there was an obstetrician or a dentist or a spiritual healer I hadn't noticed among the internists, cardiologists, and ear, nose and throat types on the floor. But no, not a one. Could she be someone's driver? Nope. She walked straight up to the desk on the other side of the reception area to get the forms for more tests.

I know I was that young once. I'm quite certain I was never that beautiful. But it was the carefree part I couldn't stop thinking about. Was I ever that carefree? Had life been so good to her that she had not yet learned to fear what might lurk around the next corner?

These days, I spend a lot of time trying not to worry. I think about the ocean when I'm trying to push away the other thoughts. I think about the ocean a lot.

My doctor was telling me how, when he sits down with his family this week, they will go around the table and each person will say what they are thankful for. Kids sometimes have trouble thinking of what to say. The older you are, the easier it gets.

I remember a time, many years ago, when my biggest worry on Thanksgiving was whether Marblehead would beat Swampscott in a game of football that almost everyone — winners and losers — would forget about the next day. In those days, I worried about things like whether my sister would make fun of me for being chubby, whether my mother would actually sit at the table, and who would get stuck doing the dishes. I didn't really understand what it meant to be thankful because I didn't really understand loss. The irony, of course, is that the more pain you face, the more you have to be thankful for.

My parents are both gone. My brother and sister are far away. It has not been easy for any of us. I have faced defeats far more crushing than the Thanksgiving football game, lost friends I loved dearly, spent too many days sitting in too many hospitals praying in case it helped. I can't imagine ever being as carefree as I was on those Thanksgivings so long ago, or as the young and beautiful woman in the elevator.

But I have learned what it means to be thankful. To be thankful is to understand that things don't have to work out, no matter what you do, that life is not always fair, no matter how hard you try, that being good and doing good don't guarantee anything, not even a night's sleep.

Knowing that can leave you angry and bitter and disappointed, and like most people, I sometimes feel that way, sometimes more often than I'd like. But it can also illuminate the path to true gratitude: to being grateful for things that turn out better than they might, to friends who are still there, to the family I have. I know too much to be carefree. But the other half of that is that I know enough to be grateful.

Happy thanksgiving. God bless.

To find out more about Susan Estrich and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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