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...

New Year, New Life

First of all, Happy New Year!!!

As I write, it is December 31st, the last day of 2012.  The world did not end 10 days ago.... was I the only one that thought it would kind of take care of some problems if it did end?  But I digress...

As this new year is about to begin, I find myself surprisingly optimistic. I long ago gave up New Year's resolutions in favor of trying to be mindful every day (well, most days) (well, many days) of health and good habits. And so, while I have no distinct promises I'm making, I am excited to see what happens in this new year.  Last year, I had just left my career behind and had not yet found my way into my current employment.  I hadn't even started looking for work yet, but I was still terrified, as I really had no idea what I was going to do to make money.  This year, my freelance editing business is slowly starting to become more lucrative.  For the first time this month, I made enough to a) not have to draw on my savings account, and b) pay off a little of the debt I'd let build up.  I have enough projects lined up to keep this trend going for at least another couple months, and hopefully enough irons in the fire to bring in new work after that... This might actually turn into a real business!

I am also optimistic about my personal life.  As I get better-paying projects and can actually take days off here and there, my husband and I have been able to spend more quality time together, and who knows!  We may even start planning our belated honeymoon!  Or at least take another trip to the coast if the honeymoon is still a little out of reach.  And as I am able to relax, at least a little, about money, I am able to focus energy once again on personal growth.  Unfortunately, that's the tough stuff... having money worries was a nice excuse to not work on my issues, just as working 90-hour weeks used to be.  Here's to stripping away the excuses! Cheers (I think)!

These past two years have been a bit rough, with the one bright spot of my (awesome!) wedding as the exception proving the rule.  There were some big decisions made and big leaps taken during these last couple years, and I was plagued by a lot of worry, doubt, and self-deprecating thoughts. I don't know that 2013 will necessarily be any easier, but I do know that I am getting sleep (in my own bed, no less!) every night, working steadily, communicating with my partner, and toiling away, however slowly, at self-knowledge and self-improvement. A very wise person reminded me recently that peace is not the absence of adversity and hard work; rather, it is the ability to have a calm mind in the midst of those things.

Here's to peace in 2013!  I'll raise a glass to that!
Namaste, everyone.

Delayed Gratification. Wait for it....

It's almost Thanksgiving!  Where has the time gone?

As the gorgeous fall leaves fall from the trees and every other person on Facebook seems to be posting daily "I am grateful for..." lists, I have been thinking a lot about gratitude and its sort-of cousin, gratification.  I've been meaning to write on the topic of delayed gratification for quite some time, and this month of gratitude seems as good a time as any!

Physicians are experts at delayed gratification.  Really, anyone who is a Type A, workaholic, good student, etc has to be.  Studying now rather than going out to the movies - making a sacrifice that will pay off in the long-term - is what delayed gratification is all about.  The understanding is that you are giving things up, but the rewards will be worth it.  And delayed gratification serves a purpose.  Waiting until the weekend to eat that ice cream provides motivation to eat healthy during the week. Claiming that diploma at the end of 4 years of hard work, whether it's high school, college, or medical school, is the gratification payback for all the sacrifices that have been made (emotional, financial, personal, etc).

"I'll be happy once I read all these books!"

But what if you get there, to the place of "gratification,"  and it isn't what you thought it was going to be? The ice cream is that gross low-carb stuff, or you find yourself utterly uninterested in pursuing the work that your diploma prepared you for.  Does that mean you made those sacrifices for nothing?  I don't think so at all.  I may have spent 12 years of my life getting to where I was, only to find that I was not happy.  I may have gotten to the point where I was finally making enough money to pay off my loans and my mortgage and take nice vacations, only to jump into the financial insecurity of freelance work (something I NEVER thought I would do, mind you... a topic for another time).  But that doesn't mean those 12 years were wasted. It doesn't mean I'm not using my medical education.  And even if I weren't using that hard-earned education - even if I were slinging coffee in a diner somewhere - those 12 years would still have been worth it.  Those years were a journey, and there were lessons to be learned along the way.  Although you couldn't have convinced my goal-oriented Type A self of that at the time...  (nothing against coffee-slingers, by the way!  I've been there too)

College to some degree, and medical school to the nth degree, were all about chasing the next exam, preparing for the next hoop to jump through, all the while thinking that I would be happy when that next thing was accomplished.  "I can catch up on my sleep once finals are over."  "I can relax once I've passed the boards." "I'll be happy once I finally move back to the Northwest."  (OK, that last one was true!)  But there's always something else.  There's always another exam, another hoop. It took me almost 40 years, but I finally figured out that I was missing something by putting on the blinders and plowing ahead toward my goals.  It's tempting to think of those years as wasted. In terms of personal growth, I certainly missed out on time I could have been using to figure myself out.  But maybe I worked so hard BECAUSE I wasn't ready to go on that journey yet.  So I took a different journey.

Who knows what my life would be like right now, or what I myself would be like right now, if I hadn't had those experiences, good and bad.  Maybe I would be happier, maybe not. Maybe I would have skipped living in some places I really didn't enjoy.  But then again, maybe I always would have kicked myself for not going to medical school.  Maybe I would have met my life partner 10 years ago... or maybe I never would have found him if I hadn't waited to move to my current city until we were both ready for each-other.

It was just over a year ago that I quit my job and began my journey into finding fulfillment in both my personal and professional lives.  I think back to this time last year.  The leaves were falling from the trees. The gorgeous sunny days were beginning to have a little nip to them.  I was spending a lot of time on the couch, alone at the house, decompressing from 12 years of chasing down the wrong path, pursuing the wrong dream ( nightmare?).  It was several months before I began to look for work, not really knowing where I was headed.  I'm still not sure where I will end up, but I am busy and feeling productive.  For that, I am grateful.  I delayed the gratification of my life for 12 years, and now I am grateful for all of the experiences that have led me to this place.  I am grateful for my supportive husband who knows what it is like to pursue one's calling without much of a safety net.  I am grateful for those beautiful falling leaves.  But I am still delaying gratification... I tell myself I will be happy when I am earning enough that I can stop drawing on my savings, when I won't have to work every day of the week, when my husband and I can afford "real" vacations again.  But at least I know now that's what I'm doing.  And I remind myself that delaying gratification is fine, as long as I'm taking the time for gratitude right now.

So I will take a moment to be happy, no matter what else is going on.  In this month of giving thanks, I am most grateful that this big, beautiful universe has supported me in my leap. And now, I just may go jump into a pile of leaves!

To Market To Market...

Wow, it has been 3 months since I've posted anything!  I guess you can tell that I've gotten busy with editing work.  That's both good and bad...  I am working like crazy, which is good, but I'm working like crazy, which is bad!  Working 7 days a week is a bit tiring, and it has left me no time to blog, work on my book, or do anything creative!  Luckily, I will hopefully soon be able to ease up on the work-a-thon...  I have just returned from the American Medical Writers Association annual conference and learned a thing or two about marketing myself, and finding clients that will pay me what I'm worth!  I wrote the following right after (okay, maybe parts of it during) my marketing seminar:

I have never been comfortable promoting myself.  When I was in medical school, I would describe myself as "just" a medical student.  That "just" seemed to take some responsibility off my shoulders, and it allowed me to keep telling myself the story that I was worth less than other people.  Once I was a physician, in residency and beyond, you really had to pry it out of me that I had MD after my name.  If someone asked me where I worked, I would reply, "in a hospital," which was usually followed by the question, "oh, are you a nurse?"  and the questioner's embarrassed justification when I finally revealed, "no, actually, I'm a physician."  Part of me took a perverse pleasure in exposing the inherent sexism in the question, and part of me cringed at being "exposed" as a doctor (see, Why Doctors Suck).  I always wanted to distance myself from the stereotype of physicians as arrogant, entitled jackasses, and part of me was reluctant to claim the credit for years of hard work and financial, personal, and emotional sacrifice. I didn't want to be perceived as "bragging" or to have an inflated sense of my own worth, but I went too far in the other direction, downplaying my intelligence, drive, persistence, and personal value.

I am currently at a conference of medical writers and editors, where I attended a workshop on marketing.  This is basically anathema to a person who grew up downplaying her abilities and achievements.  It has taken me a long time to learn that there is a big difference between "bragging" and owning my own worth, both as a highly educated individual who deserves recognition and compensation for her hard work, and as a human being who deserves love and happiness.  I had to learn the difference between confidence and arrogance, and that it was okay to be confident.  Nobody was going to smack me down for pretending to be being so great.  Now, I have to learn how to present myself and my services in a way that will make people want to hire me. Hard to do when you approach every situation assuming that they won't.

Let's practice a little....  People will want to hire me.  People will want to hang out with me, even though I may think I'm boring and dull, with nothing to say.  Okay, hang on...  despite this negative self-talk creeping in, I do have people in my life that like me, love me, and even people who want to spend time with me and to hear what I have to say.

My marketing instructor made a comment that I am SO SICK of hearing, but also that I probably need to keep hearing.  I complained that I am working for companies that don't pay very well, certainly for someone with an advanced degree.  He told me that these companies will only pay me low rates if I let them.  Grrr...  I get so frustrated, because if I'm not working for these companies (who were willing to take a chance on an inexperienced editor), then I'm not working, and I'm out on the street because I can't pay my mortgage.  The people who make comments like, "they'll only pay you those rates if you let them!" don't seem to take into account that this may have been (or seemed like) the only option at the time, and crappy pay is better than no pay.

But I do recognize that I need to step back from that personal, emotional response and hear what people are actually trying to say (sorry, instructor, for bursting into tears at the break).  You are worth more than this.  Your degree and your experience are worth more than this.  Your personality, your soul, your self is worth something.  To quote The Help, "I is smart, I is special, I is loved."

And that is worth something.

Promoting myself as someone people will want to hire, and to pay well, is a challenge.  It requires not selling myself short.   How's this for an editing and self-promotion slogan:

I'm here!  I'm clear!  Get used to it!

How are your dangling participles doing?

When I left my physician career behind, I wasn't really sure where I'd end up. 

Well, to be honest, I kind of had an idea (a type A uber-planner doesn't just leave behind her career without at least a wisp of a plan, as hard as she tries to "let go" and not have a plan). I had joined the American Medical Writer's Association (AMWA) and registered for their annual conference - conveniently, taking place just a couple weeks after my last day at the hospital.  I had an idea in my head that, after some time off to decompress and veg on the couch, I would make a foray into medical writing.  This is a vast and diverse field, with plenty of niches within it - I pictured myself getting involved in continuing medical education (CME) and writing articles for other physicians to read. They say to write what you know, no?

I went to the conference and immediately discovered two things.  One, writers are much more supportive of each other than physicians are.  Two, I really need to brush up on grammar.  Knowing what "sounds right" isn't going to cut it.  Okay, three things.  Three, I like grammar!

I returned home and duly fulfilled my destiny of vegging on the couch for a good while.  For a time, I was worried that I would never be motivated to go back to work, as I really enjoyed the couch-vegging lifestyle.  A lot.  My day was divided between classes at the gym and Netflixed TV shows.  I kinda loved it.  But eventually, I did start to get that niggling feeling that I should be doing something, well, productive with my life. And I started to look for jobs writing CME.

This was not as straightforward as it may sound, as I really wanted to try for a telecommuting position.  After more than a decade on the end of a pager, setting my own schedule and working from home sounded awfully nice. I did find a CME company willing to pay me to write an article, so I dove in.  And realized that I hated it.  Writing this blog and writing my experiences into a book are an entirely different animal than writing a scientific article.  The former flows out of me; the latter is like pulling teeth. I also did not like the feeling that I was writing a gigantic term paper that would be judged not only by my professor, but also by any physician who might read this article for their education. It had to be perfect, and I had had about enough of demanded-perfection in my old career.

In continuing to haunt the job boards of AMWA and websites dedicated to telecommuting, I found myself applying for (and getting!) editing jobs.  Non-native English speakers do a lot of the research in this world, and they want to publish their papers in the English journals.  That's where I come in!  I take my newfound love of grammar and mix it up with some study of the American Medical Association guidelines for scientific journals, and it all bakes up into a career as a freelance editor!  And, wonder of wonders, I love it!  I get to correct people's grammar (always fun), and I get to learn about something different every day.  One day I might have an article on dermatology, the next on cardiology, and the next on gynecology.  It's bringing back the love of medicine and knowledge that took me to medical school in the first place.

I don't know if this will be a long-term career, or just a stepping stone to something different, but for now it's (almost) paying the bills and providing me with a sense of purpose.  I am also building my own business, something I never thought I would do in this lifetime.  A psychic told me a few years ago that I would have my own practice/business at some point, and I thought she was insane.  I loved collecting a salary, and had absolutely no interest in striking out on my own into the scary world of non-financial security that is one's own business. 

Moral of the story:  never say never (or, never contradict a psychic, one or the other...)