We embarked on this family adventure because we were looking for something: a broader education for the kids, a defining family experience, and an alternative to a job that I was finding increasingly exhausting. Why would anyone want to leave medicine? I’ve spent a lot of time over the last six months trying to figure out why I felt so compelled to leave the job that should have been my life’s work.
What medicine was
When I got into medical school I was ecstatic. The future was bright with dreams of challenging and rewarding work that was also well-remunerated. I could work part time and travel – maybe on the front lines in a foreign country with Doctors Without Borders. A big house, luxury cars and status weren’t important. I wanted noble challenges, adventure, a life that mattered.
In hindsight, medical school was bliss. We gripped our golden tickets as we entered what felt like an elite club full of smart, resourceful, benevolent people. Suddenly, I was motivated not just to perform well on tests but to really learn and understand. The long hours and challenging problems were a source of satisfaction, not suffering.
I read once that you’ve found your calling when a great need of humanity matches a great passion of the individual. When I found emergency medicine, it felt like a calling. I worked harder than ever. William Osler, the father of western medicine, said that “Medicine is a science of uncertainty and an art of probability.” The acuity, diversity, intimacy . . . somehow it all meshed with my circuitry. I could almost feel the buzz and glow of my nervous system as I assessed, diagnosed, treated, empathized, consoled, supported.
Over time the pipe-dreams of part time schedules and international medical work gave way to marriage and babies (a good trade), but I thrived on the challenges and felt both pride and privilege to be serving in that role.
What medicine became
Then slowly things began to change. I realized that the hardest thing about medicine was not missing knowledge, it was missing resources: knowing what patients needed but being unable to access those things (or else having to fight tooth and nail for them). How could this happen in Canada?! Constantly apologizing for long wait times, hallway admissions, disappointing experiences – none of which were in my control – ate away at me. At the same time regulatory college, government, and administrative powers picked and pulled at physician autonomy. Doctors should comply with policies that protect patients, but what if those policies are poison to that fundamental and sacred relationship?
Gradually my calling turned into a job. It’s one thing to work your ass off for a higher purpose. It’s another thing to work your ass off for money. A recent study revealed that the biggest factor in male happiness was not money, health or even a happy marriage, it was job satisfaction – specifically, the belief that one’s efforts are contributing to their organization’s growth. I was a cog in a grinding antiquated machine. I wanted to be a spark in an evolving entity.
I tried to be proactive. I accepted leadership roles, joined teams. I worked out and ate well. I renovated our basement then became general contractor in the construction of our “dream home”. We moved. I renovated another house. I wrote personal finance articles, brewed beer, designed beer labels, made business plans and started (or nearly started) three businesses.
I kept on piling more things into my life because I felt unbalanced. ER work was on one side of the scale, everything else was on the other side. The hospital exhausted me more and more so I took on more and more outside of it. Sometimes the busyness was thrilling – “Look at everything I’m accomplishing!” – but something wasn’t right. It is possible to enjoy something that isn’t good for you – just ask a cocaine addict. I got headaches. I stopped sleeping. Socrates said, “Beware the barenness of a busy life.” In theory, I had a very “balanced” lifestyle. In reality, I was breaking the scale.
We are a restless species. There is a biological drive to act, to acquire, to be more, to have more. Maybe that was okay ten thousand years ago when there wasn’t a lot to grasp for, when rest was built in to the system because there was no choice but to wait for the next thing. Evolution likely selected for those who jumped into action when opportunities arose. The problem now is that opportunity is constant and ubiquitous. There is no rest unless you seek it out and harvest it.
The decision to sell our house and try out this family world travel thing was really just the latest – and most extreme – attempt to find balance. The irony is that to do this, we had to take almost everything off the scale – work, house, all the possessions that promise happiness but just weigh us down – this is what I needed all along.
What is left is Linds, the boys, six backpacks, some bank accounts and this blog. We meet people and learn things and sometimes don’t do much of anything. It has taken some getting used to. The scale moves more when it’s lighter.
I’m quite sure no one would have been able to convince me to downsize my life like this, so I don’t think this post is going to change anyone else’s life. At best, I might have tried eliminating a thing or two, but it wouldn’t have been enough – and it’s uncomfortable at first when you’re so used to being busy. I had to stumble into this, like walking in a dark attic and bashing your shin on something you’ve been looking for for years.
Out of the six of us, I think I needed this trip the most – and I’ve also had the hardest time adjusting. There were a few months where I felt really uneasy – you might say “out of balance”. All the things I had taken on had weighed too heavily, but they had also been familiar and grounding. If I’m not an ER doc, who am I? If I’m not busy, am I being productive? And the one I struggled with the most some days: If I’m living the dream, why am I not happy? One night I stayed up late pouring my angst into an email to a very wise friend. His reply:
You are in the midst of an adjustment disorder. Inertia, familiarity, routine, what is known and predictable is comfortable. Not necessarily good, but comfortable. You have chosen, bravely, to confront and confound that and so not surprisingly you are uncomfortable. Stay committed to it. Feel it out. Experience it. You probably won’t do this again, so eat it up and revel in it, even if it makes you transiently unhappy.
I needed reminding that it’s ok not to feel happy because this is not about happiness. It’s about family and discovery and exploration. Things that are bad for you in the long run can feel good right now, and things that are good for you in the long run can feel bad in the present. Usually that means there is some adaptation that needs to take place. Ironically, this made me a lot happier.
But what about medicine?
I’ve never had a failed marriage, but I imagine leaving a career like medicine might be similar to the end of a dysfunctional relationship. You try hard for as long as you can to make it work until you run out of things to try. Leaving is scary and unsettling and exciting. It takes a while to find your feet again, to adapt, and even then there will be times of confusion when you might miss the good parts of that thing you knew had to end. But would things be different if you went back? Have you changed? Have they changed?
I thought medicine would give me the life of noble challenges, adventure, and meaning that I wanted – and it did for a while. Perhaps it will again someday – I haven’t ruled that out. But, if I’m honest with myself, as hard as it is to let go of that identity, it’s even harder to imagine going back. I have found challenge, adventure, and meaning again in a different place – out here. Sometimes your calling changes.