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Breaking up with medicine

Entering a profession is like entering a relationship. You do what feels right at the time, based on your best judgement of the other partner. You seem to share the same values. You like what they have to offer and they like what you have to offer. The intoxicating elixir of awe at what is and excitement of what could be sets in. Your pupils dilate and a warm tingly feeling rising up your inferior vena cava tells you, “this is good.” Even your social group celebrates the connection. And deep in your brain, a switch is flipped.

With optimism and confidence, you commit. Why wouldn’t you? It’s gonna be great. You’re better together. Because even though you’re both unique – a culmination of events and experiences; complex individuals – somehow you fit together so well. You found each other and, finally, everything is going to be okay. Better than okay.

But we forget two things.

First, we aren’t actually committing to our partner. We are committing to our perception of our partner. A gestalt of observations and experiences. A mosaic of snippets. A compilation of what they put out into the world, seen through the lens of our own hopes and biases.

Second, change doesn’t stop just because you’re together. You’re still changing. They’re still changing. Nothing and no one is an endpoint. We’re snapshots along a developmental path. Sometimes those paths are divergent.

It’s okay if you get further apart on the little things: tastes in food, interests in hobbies, your favourite Netflix series – as long as your fundamental values are aligned. But what if they’re not? What if what is fundamentally, existentially, non-negotiably important for you is, for them, an afterthought.

I think this happens in medicine all the time as doctors try to put the health and welfare of their patients first while “the system” that they are married to is primarily concerned with allocating finite resources, balancing budgets, and (shudder) worrying about the political fallout of their decisions.

How many physicians really knew the career they were marrying? I didn’t.

Sometimes good relationships become unhappy and dysfunctional with time. Are the sunk costs reason to stay? As much as we crave certainty, living necessitates frequent leaps of faith.

Some people make medicine the plot of their whole life story. That’s wonderful, it’s just not me – and I suspect there are a lot of us feeling the same way. For me, there was no happy ending at the end of a life defined by medicine. Instead, I often describe my decision to leave medicine as being like the end of a chapter in my life.

It was a really important and meaningful chapter that developed the plot enormously, but turned out not to be the overarching theme of my book. And so, I turned the page . . . and the page was blank. The story was not written. WTF? This is uncomfortable. What’s next?

Right. Of course. I have to write this story. We all have to write our stories. Some people plan theirs out and stick to the plan. But I wasn’t happy with the Hallmark storyline of Dr. Poyner fighting a deficient health care system for the sake of his patients for the rest of his life. This plot twist is mine, and I have to own it. I’ve only got one story. Let’s make it interesting.

Most people live with a scarcity mindset. They overvalue what they have and, because of that, the idea of letting go of what they have is scary. They think they’ll be left with less.

But what they’re not seeing is all the things they could have, that they could experience, if they just let those tired hands release their white-knuckled grip on that tiny slice of familiar reality. If they can do that, let it go, let it fall away, and then look up . . . sometimes they’ll see that their vision had been blocked and there are dozens, even hundreds, of exciting paths to choose from.

They’re not left with less, but open to more. Not scarcity, but abundance. And suddenly their fingers and hands are filled with strength and energy to build something new. A reinvention. A leap of faith.

As long as you’re still sucking in oxygen and puffing out CO2, leaving medicine is never the end of the story, it’s a transition.

In my case, we saw those blank pages and decided it was a good time to do something BIG. We wrote another chapter by traveling around the world for a year as a family. That was amazing – as much of a journey on the inside as on the outside.

Now we’re writing another chapter by living in a small town where we can walk to everything and our cost of living is reasonable enough that making an income is optional. I work at what matters to me and it gives me energy rather than taking it away.

It’s okay that we don’t know what’s going to happen next in our story. The pages are blank but we are the authors, no one else. Besides, the best stories are full of surprises.

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