And now for something completely different

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OK, time for a bit of a change-up.

I feel that this blog has become a little repetitive. I am completely at peace with my decision to leave medicine, but I realize I wasn't coming across that way, as I kept harping on the topic. Time to start branching out. I will (mostly) save the delving-into-why-I-left-medicine for the book I'm (supposedly) writing (including lots of gory details I haven't yet gotten into here), and start to explore some new topics on Ye Olde Blogge.

Change is good. I have always been a person who changed paths every few years. What on earth made me think I could stick it out for 30 or 40 years in one career? Or for very long on a single-topic blog, for that matter... After four years of high school, I was off to spend a year in Sweden as an exchange student. Back home, I went to college for four and a half years. Then another year abroad, working in Ireland and Scotland. Then back home again, working in clinical research for a year and a half while I applied to medical school. Four years back east for med school, then four years in the desert for residency. I liked making a change every few years, although I was mighty sick of moving. I am now resettled in the beautiful Pacific Northwest. I hope never to leave, but I like the idea of changing directions every few years, keeping things fresh. How did I ever decide to commit myself to a lifelong career path? I was clearly not listening to ALL the voices in my head, including the ones that indulged in two minors in the Humanities.

I have been radio-silent on this blog for awhile.. Not only was I feeling stuck in a topic-rut, but I was plugging away on the editing work pretty much every day. While I enjoyed (and still do enjoy) that work, I had a wonderful opportunity come up to make a shift (again with the change!) into clinical informatics. What now, you say? Clinical informatics is basically the effort to disseminate medical information in a meaningful way. In the case of my current project, it is making electronic medical records make sense by standardizing terminology. (You can't imagine how many ways people come up with to say the same thing!) Anyway, I got out of the habit of writing, even as my new job freed up some time to write. This has been a very positive change, exposing me to a field I didn't really know existed. And I still have time to do some freelance editing, keeping a toe in that pool and maintaining some variety in my work week.

And so I am embracing the change. My path away from my previous career track has led me here, and I couldn't be more thrilled! They say that nobody expects the Spanish Inquisition... well, when I was in medical school and residency, I never expected to be working from home at a job that makes me happy and making enough money to cover the mortgage! It is completely different from my previous life, and that suits me just fine. What will I be doing in 10 years? Or even 5 years? Who knows! That's the exciting part. Life's too short to do anything other than what makes you happy... and apparently change makes me happy. So stay tuned... and expect the unexpected...

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Stupid/Clever/Brave

A wise man once said, "there's a fine line between stupid and clever."  Oh wait, it was Nigel from Spinal Tap.

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When I tell people that I left the practice of medicine, many respond with a comment that I was brave, or courageous, or some similar descriptor, to make that decision. I always wonder if "brave" means "stupid," and they're just trying to come across as positive... but they're really thinking, "why would she go and do a dumb thing like that?"

Why would someone voluntarily walk away from a lucrative career, especially after spending years (and a small fortune in loans) getting there? I am sure the answer is slightly different for anyone who has made such a move, so I can only answer for myself. And my answer is that I was deeply unhappy (that's the very short version). And I think it was both stupid and brave of me to make that decision and to act on it.

Stupid because I have loans to pay back. Stupid because I have a hefty mortgage on a house that's taken a nosedive in value since I bought it. Stupid because there were parts of my job that I loved. But brave for all those reasons, too. Brave because I made the decision to get out, rather than spending the next 30 years in unhappiness, feeling trapped, counting the hours until retirement. Brave because I decided to take my future into my own hands instead of letting the medical culture, society, or anyone else tell me what I "should" do, what was expected of me. Brave because I chose not to listen to people who thought I was stupid. (mostly they were too polite to tell me to my face, but come on, you can tell when people think you're off your rocker...)

I would like to appropriate Sir Nigel's (surely he must have been knighted by now!) statement and claim that there is a fine line between bravery and foolhardiness. Perhaps it was foolhardy to take on the financial risk of quitting my career. But I feel that the foolhardiness would have been greater in staying. My mental health, my soul, is worth more to me. I have had more than one person tell me that they "lost their soul" somewhere along the path to practicing medicine. More than one person used those identical words. And so I chose to stop. To find my soul again. To find my sanity again. To cherish my marriage. And I think that was rather clever, if I do say so myself.

Beautiful Mistakes

Once in every "generation" of doctors, however long that is, someone comes along who is a true risk-taker, who breaks the rules and comes up with a revolutionary way of doing something - of treating a disease, of thinking about wellness, of making a connection between concepts that had been considered unrelated.   That person is often branded with the "quack" or "renegade" label, until history takes a look back with the benefit of perspective. How whacked-out do you think people thought it was when Edward Jenner was injecting people with cowpox, based on the observation that milkmaids who recovered from the disease were immune to smallpox?

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As recently as the 1980s, people were calling for the firing of C. Everett Koop when he was advocating sex education in the schools and the use of condoms to protect against HIV.  Nowadays it seems that changes in paradigms of medical thinking are coming along faster than we can keep up with  (Coconut oil is the devil - no, wait - coconut oil is good for you!).

Sometimes these revolutionary changes come about because of mistakes, or accidents. Take penicillin, for example... if Fleming hadn't left that orange sitting out... However, the current culture of medicine pretty much actively discourages these mistakes. Taking chances, depending on the context, can be tantamount to malpractice, and there are legions of lawyers out there just waiting for you to step into their clutches (for those of you who think I'm lawyer-bashing, maybe I am just a wee bit, but I also freely doctor-bash as well. See Why Doctors Suck for equal opportunity).

I am a recovering perfectionist, and medicine at first seemed like a perfect fit. How better to beat yourself up over every little mistake, if that mistake might kill or injure someone?  But as I have come to learn who I am deep down, and to forgive myself for falling short of perfection, I have realized that I want to have a job where it's okay to make a mistake.  Where it's okay to prioritize myself and my family. I want the freedom to be human. I want to be free to take chances. I want to be present for my life, rather than perpetually exhausted and stressed out. I realized that I wanted a Medical Divorce. And it really is a divorce - walking away from the investment of years of my life, and hundreds of thousands of my dollars, not to mention my outward identity and the respect and/or censure people attach to physicians in this culture.

My previous way of life devalued mistakes, chances, and evolution. I chose to step away, and to allow myself to evolve into the person I was truly meant to be. That person is still a work in progress, but at least I'm free now to make the beautiful mistakes that will get me there eventually.

The power of tears

A few weeks ago, I went with my mother to see the new movie version of "Les Miserables." And I cried. "Of course you did," a reasonable person would say, "it was a sad movie." Yes, it was a sad movie, and at a couple points it was all I could do not to sob out loud. Right around the same time, I had a good cry at the end of a book with a particularly poignant ending. It felt good to cry, and then I realized why... my tears were back!

For several years, I lost the ability to cry. It started sometime early in residency, I think. Right around the time I should have been realizing that I wasn't happy with my life and that I was on the wrong track. Rather than realize those uncomfortable truths, I shoved everything down, pretending that I was only unhappy because of the work hours, which would exhaust anyone, and with the fact that I was living in a city I heartily disliked. In fact, the last good cry I had was when I was matched to this city for my residency. I liked the program itself, so much so that it would have been my #1 choice had it been located elsewhere, but the thought of living in this locale, so foreign to the landscape I grew up in and to which I was hoping to return after 4 years on the opposite coast for medical school, left me in tears. Maybe I was even crying because I realized on some level that residency itself was the wrong path for me... who knows... I sobbed out all those tears, not realizing that that was it for awhile.

image credit: Time-Entertainment.

Oh sure, I was able to cry here and there. Like when I was getting on the plane to go back to the residency grind after a vacation with loved ones. Like when something particularly upsetting happened. Like when we had to put my parents' old cat to sleep. But it was never a good cry. I was never able to let go and sob, even when I wanted to and needed to. I would feel it coming on - a few tears would escape - and then it would dry up. I think that somewhere deep down, I was afraid that if I really let go and sobbed, that that emotional release would open up all the other floodgates and let out all the truths I had penned up behind them.

And so I plowed ahead with my education. There were enough parts that I truly did love (delivering babies!) that I could convince myself it was just residency... things would be better later on. And predictably, by the end of residency I had become the worst version of myself. To anyone who knew me then, especially to anyone who knew me only then, I wholeheartedly apologize. I was so miserable, and so unwilling to admit to myself that I was on the wrong path, that I was strictly in survival mode.

I was lonely, and yet I sabotaged relationships so that I could remain unhappy. After all, that was what I deserved, I told myself. Unhappy in work, unhappy in love. When I moved to my present city after residency, I was so happy to be back in the locale of my dreams that I manifested that happiness into meeting my life partner. And once I was happy in my personal life, I finally had the courage to look at my professional life and realize how deeply wrong I had gone. The tears started edging back as I slowly came to the decision to leave the practice of medicine. Of course, this took time. I still had to have some truly awful moments before I could wake myself up to the fact that I was meant to do something else with my incredible (and incredibly expensive!) education. And even after I left, it took over a year for the tears to truly flow again.

I read an interview in Time magazine and tore out the corner of the page because one passage spoke to me... unfortunately, I left behind the part of the page with the name of the person quoted, so I am unable to give appropriate credit, but here is the statement:

You come into the world screaming. You cry when you're born because your lungs expand. You breathe. I think that's really kind of significant. You come into the world crying, and it's a sign that you're alive.

I am finally able to cry again, as I  begin my life over again. And I wonder: why, when we see someone in tears, do we inevitably say, "don't cry?" Is it because we don't want someone we care about to be sad, or is it because we are uncomfortable witnessing those tears - that outpouring of undeniable emotion? That life force? That fresh start? Maybe it's time we said, "cry!" And treat that person to a showing of Les Mis...