I seem to grow bolder with time

Confidence is a funny thing. It gains momentum like a snowball, but loses it just as quickly. Often seems all-or-nothing (or unfounded, or just resting in the wrong reasons) and rarely seems balanced at all. My friend feeling "fattish lately" and other evidences of insecurities. I want to tell that my friend looks great, and I do, but I don't think I'm taken seriously. Is it a problem that I'm "nice" to eveyone because then no one feels special? I can't buy it, but I must consider it.

Thinking of new friends and old ones (that grow and fade in closeness) and my relationships/committment to friends and patients. The balance between pouring oneself out too much at work, and being an advocate who works (rightly so) furiously to help. I definately see good outcomes when pouring oneself out for the patients, but at what cost? Taking a sick day every week? Not sustainable. Tightrope of impossibilities.