When we tell people that we sold our house and most of our stuff to travel around the world with our kids, the response is often: “Wow, you’re brave!”
But it’s not true. Bravery is action in the face of risk. Traveling is many things – exciting, challenging, uncertain – but it is not particularly risky.
What was risky was to continue doing what we were doing: the kids trapped in a struggling educational system, me being worn down by a broken health care system, Lindsay watching us, powerless. All of it costing money and, more importantly, time that we could be spending together as a family.
Once we wrapped our heads around the idea of full time travel, the risky thing would have been to stay.
A break vs. a change
Some families travel as a break from normal life. We traveled to find a new normal. What would that look like? We didn’t know, but as Albert Einstein said: the definition of insanity is doing the same thing over and over again expecting a different result. Perhaps we could try a few things and see where that landed us. The worst that could happen would be a discovery that good ol’ “normal” was as good as it gets and we could jump back on that bandwagon with confidence and enthusiasm.
Alternatives to “normal”
Almost nine months later, we have seriously investigated several alternatives to “normal”. Lifestyles that would have seemed radical a year ago are now on the table as viable options: buying a boat and sailing around the world, slow travel in various exotic locations, settling down and starting a life somewhere else. Paths that once seemed far-fetched are now laid out in front of us, waiting for us to make up our minds.
All of these options had one thing in common for me: leaving medicine for good – and I was ready for that. The state of emergency departments in Canada is dismal; burnout is rampant; and there aren’t many signs to be hopeful about the future. On the other hand, communities need their emergency departments more than ever; from a knowledge and experience point of view, I am at the peak of my career; and, just as I was “burning out”, several exciting projects and opportunities were opening up for me.
I turned my back on all of those opportunities, because I was out of gas and the thought of exploring the world with my family was infinitely more appealing. For months I’ve been describing medicine as a chapter in my life, rather than the whole book. I was ready to move on.
A funny thing happened in Hanoi . . .
But a funny thing happened about a month ago in Vietnam. I was working out at a dusty old gym in Hanoi and it occurred to me that I am not ready to close the door on medicine. If we were to continue traveling beyond a year, it would simply be too long an absence from the ER. My skills would wane, my knowledge would be out of date – I wouldn’t be able to return.
More importantly, I realized that the thought of working in the ER again did not elicit involuntary shudders and overwhelming nihilism. This was a change. There was even a little . . . could it be? . . . excitement? There are lots of things about emergency medicine I grew to resent over the years, but the core mission of helping people when they need it the most was – and still is – thrilling. The fact is, I have a skill set, developed over those years, that makes me particularly suited to that role.
Skill, challenge, and meaning
It’s a little like studying to play the piano. After years of practice and performance it becomes part of you. Songs that would be hard for some, impossible for others, jump from your fingers. Challenging pieces are even more fun: when the level of difficulty is matched by your skill, nudging it higher – that is the soul-swelling meaning of all that hard work, maybe even part of the meaning of life. What would make you stop playing?
In medicine, every patient brings with them a problem to solve, one that they couldn’t solve themselves. They need a doctor to shine a light, revealing the necessary information and assembling those scattered pieces, carefully, with kindness, into something that is understandable. Perhaps not a diagnosis, but at least a plan. Calm the fear. Order the chaos. That’s the kind of music we play.
Playing a broken instrument
Much of time a doctor’s work is gritty and graceless. It’s not like sitting down in front of black and white keys that are always arranged and behave the same way. The instrument we’re trying to play is the health care system and it’s a great big blundering, broken machine. Parts are missing, others don’t work right, and there is almost no margin for error.
So, we’re often frustrated because we feel capable of creating beautiful music but have to settle for a squeaking, honking rendition of what good care would look like. We know how the song should sound, we talk about how it should be performed and yet . . . Patients are disappointed. We’re disappointed.
Like so many others, this constant frustration wore me down (keep this in mind next time you see a doctor). Some physicians seem to accept the limitations of the system better than others: dangerously long wait times, hallway medicine, limited access to essential resources . . . I could never box these problems away. Instead, unable to lower my standards, I suffered them alongside my patients (and was guilty by association). Death by a thousand cuts.
And yet, who better to navigate this convoluted mass of keys and strings and tubes? The patients are still arriving – scared, hopeful, needful. Their problems don’t stop, and after they endure the torture of the waiting room, who are they going to see?
After thirteen years of emergency medicine, I hate the system because I know the system. And it might not be pretty, but I can make it play. A good pianist can still pull songs from a broken piano.
The prodigal physician
I’m no martyr. I’ve proven that I can leave. But can I find a way back? Not for the money, rather for the meaning that comes from using unique and hard-won skills to solve important problems: to help people who need helping.
I’ve said before that leaving medicine was like the end of a relationship for me – I could only imagine going back if either the system had changed or I had changed. Perhaps I was wrong. Perhaps the relationship has a future with some new ground rules.
We’re coming home
So here’s the plan: We’re not sailing. We’re not moving to Malaysia. After we complete a full year of travel (August 2019), we’re moving back to Canada. A smaller house in a more affordable area – a home! We will homeschool the boys. Live modestly. We will still travel – a lot. And I will work – just a little – in a new department that I hope will better align with my values about medicine.
I might not be strong enough to pull this off. But, to all the future patients I thought I wouldn’t meet, I will try.