That first step was a doozy.
What did you dream of becoming when you were young? I mean very young, before you were thinking about white coats and stethoscopes? I wanted to be a skywriter, the person who flies the planes that write messages in the sky. I am not sure why this idea captured my imagination. I was well ahead of my time for social media (“Sky blogger!”). But until the cruel, hard realities of life in elementary school brought me back to earth, I had my sights set on the clouds.
Until recently, I thought that my origin story was written long ago, in college when I decided to pursue medicine. I stumbled onto the idea of becoming a physician at a time when I was feeling most empowered about my future and also least clear about what I would do. From there, my path was set; I zeroed in on becoming a doctor and did not look up again for fifteen years.
Skip ahead a few chapters: I am a doctor, I have a good job, decent hours, and I have made my parents proud. Certainly there are difficult days, but there are easy days, too, and what job doesn’t have ups-and-downs? I knew about burnout, but I thought only general surgeons working 70 hours a week had the privilege. Only in the midst of an unexpected sabbatical (the pandemic, unfortunately) did I have a chance for introspection. Somewhere deep down I had begun to sense that practicing clinical medicine was not the right career for me, but I was not fully “seeing” it yet. I was, however, drowning in clues. Future readers of my best-selling biography may say, regarding these early-middle chapters, that they were too heavy-handed trying to get the point across. “We get it”, they’ll write in reviews, “he’s unfulfilled but doesn’t realize it, let’s move on. The dramatic irony is exhausting”. I hear you. The middle drags. But it is based on a true story, so what could I do? When you spend a decade working towards a goal it can be hard to fold your hand.
There were two major issues which emerged for me. The first was that I was uninspired by my work. Put more directly, I was bored. How could I be bored by work that most would consider interesting? Solving diagnostic puzzles, treating disease, etc. should be compelling and at times it was. But mostly I was bored. It was important to admit that to myself. I was not sure why I was not more excited to go to work in the morning, but I wasn’t. It was also, however, terrifying to admit that to myself. I worried that there was something wrong with me if I did not find joy in being a doctor. That brought me to the second issue, which was a near constant state of cognitive dissonance. I thought that I should enjoy being a doctor, but I wasn’t. I enjoyed my patients personally, but I dreaded having a schedule full of them each morning. I got along with my colleagues and coworkers, but often preferred to avoid them rather than have to pretend I was as interested in work as they were. This conflict, simultaneously believing what is the “right” way to feel while also not feeling that way, is unsustainable. My strategy was to unconsciously seal it up and bury it. However, like an improperly stored nuclear rod, there were leaks. Stress, tension, and dissatisfaction were bubbling to the surface. Being unhappy at work, but then only at work, is hard. The unhappiness starts clocking overtime. It joins you for dinner with your family. It wakes you up, well before your alarm, so that you two can get in some extra time worrying before work. It is all the time.
So this, as it turns out, was the first step in career transition.
The thing about that first step is that it is really hard. It doesn’t really accomplish anything if it is not fierce and wicked. It takes a lot of force to dislodge someone from this type of path. Physicians put everything into becoming physicians, and their career becomes inseparable from their identities. One cannot, or so they think, just quit their job and do something else. Only a properly fermented, full-bodied first step can knock that kind of thinking out, and usually it takes a few rounds of bare-knuckle brawling to do it. All the worry, stress, and unhappiness are just the necessary ingredients for a proper first step.
I would posit, then, that the first step deserves a rebranding. It is not just a step. It is an origin story. My origin story was not finished when I watched that episode of “Scrubs” one afternoon freshman year and decided to become a doctor. It is being written right now! It is a surprising twist that it came this late in the narrative, but c’est la vie, and anyway formulaic stories are boring. Like any good origin story, I needed to be properly molded, shaped, and hardened for what comes next. I am still smart, hard-working, and a blast at parties. Now, however, I have valuable experience in healthcare, an M.D. after my name, and insight into what makes me tick. This first step (origin story!) imprinted me with new strengths on top of the old ones. Yes, it was unpleasant. Did Peter Parker enjoy getting bitten by a spider? No, of course not, gross. But would he go back in time and undo-it? No!
As a child I wanted to fly planes and write messages in the sky. I do not know what will actually be next. For the first time in a long time, however, I am excited to find out. Onto the next chapter!