The easiest decision

Almost four years ago, I retired from medicine at age 37.  It feels like I should be saying this in front of a group to whom I’ve pledged anonymity.  “Hi, my name is Angie.  I’m a recovering physician.”

I’ve told this story countless times to people whose responses range from confusion to concern, pity to envy.  Is a public admission is even necessary, or is it simply self-satisfying hubris?  The other day a friend sent me an essay written by a woman who had retired from medicine at 37.  I haven’t been able to read it–I think it’s something about wanting to get my own story out there before I become an accidental copycat.  So here goes!

The facts of the case are as follows:  I went to medical school straight out of college, where I met my future husband.  We moved to Arizona where I completed a residency in pediatrics and practiced  for two years before we returned back to Wisconsin.  I joined the faculty at the Medical College of Wisconsin and practiced as a pediatric hospitalist, taking care of kids ill enough to require hospitalization.  I flatter myself that I was pretty good at the job, and I especially enjoyed the teaching duties that came along with it.  I was doing well and garnered some awards and leadership positions. During this time we had two children, and we cobbled together a two-physician life with the help of nannies, family, and luck.  I grew increasingly disenchanted with my work, and I assigned most of the blame to the world of academics.  So I left MCW and joined a local general pediatric clinic–the BEST clinic imaginable.  Wonderful coworkers and patients, just really everything.  And I remained gnawingly unhappy.   And I retired.

I realize how lucky I was to indulge in contemplating my dissatisfied feelings, let alone act on them.  Were I not married to someone bringing home a nice salary on his own, there’s no way I could have retired.  I would have been trapped by my student loans.  I was lucky to be able to see leaving medicine as a viable option.  But as soon as it reached the level of viability, my decision was simple.  The hard part was getting to the point of not worrying about who I’d disappoint, what others would think, or my loss of identity.  After moving past those concerns, the idea of leaving was viable. The decision was easy and the path forward clear.   And I have a lovely spouse who greeted my decision with “you only live once” and has never once made me feel guilty about it.

Since quitting medicine, every few months I’m contacted by a colleague from my past.  They are generally going through a turmoil in their medical life and want my practical opinion and advice.  But I also serve as a living worst case scenario: I quit the thing entirely and emerged intact.  It’s like they want to touch the nail holes and confirm that I am, in fact, still alive.

Awhile back yet another female medical colleague contacted me to hash through her moderate dissatisfaction with her medical career.  I had NO IDEA that was the purpose of our lunch date.  Usually the calls come from mothers my age (for interestingly, all of the advice-seekers have been women).  However, this colleague is probably about 10 years my senior and childless.  With two of the common denominators of the typical conversation missing, I didn’t see it coming. Plus, she’s really, really good.

Even the most stalwart have these moments.  Medicine does that to a person. If she found use in my thoughts, then they are worth sharing.

Before I launch into my lessons, let me reiterate that the field of medicine remains a noble profession that is rewarding for many, my husband included.  His role as a physician is vital to his sense of self, as it is for so many of the best.  I simply wasn’t cut from that same cloth.  Further, I do not mean to discourage ANYONE who is truly called to that life and profession–for medicine is both.  I mean, instead, to allow space for anyone needing it to contemplate some of these Big Questions.

Here’s my thoughts about the process of entering medicine in general, at least in the U.S. system:

1. Once a person has matriculated in medical school, there’s no looking back.  The competition to get in is so fierce, the classes are so rigorous, the peers so singularly focused.  There is no time–either literally or metaphorically–for a medical student to pause and query:  “is this path I’m on leading to a life that I really want?”  Which is too bad because…
2. The amount of debt that most students take on to complete their medical training necessitates that they practice medicine for at least 20 years.  The repayment schedule is such that a move into a similarly well-paying position in another field is virtually impossible.
3. Most 22-year-olds have no idea what they really want in 15 years, the time when the reality of life as a physician (following the years of schooling and residency) truly sets in.  It is challenging to try and introduce the topic of work life balance and delayed child bearing to this age group, especially when they are immersed in the culture of #1.

Here’s my lessons about myself in particular, with thanks to a particularly skilled therapist:

1. I went to medical school because I was very good at school and had little confidence in anything else about myself.  Believe it or not, I fell rather thoughtlessly into the decision.
2. I ignored many warning signs of my poor fit and developed unhealthy coping mechanisms to deal with them.  However…..
3. I met my most important people through these life decisions and, therefore, wouldn’t change them for anything.
4. Medicine is an especially difficult profession to emotionally manage if you are a people-pleaser by nature.  And paradoxically we pleasers make especially good providers.

If people are at all interested, I plan to break down in an occasionally amusing fashion some of those numbered items above.  It’s hard to admit things like this, but at least now I can go read that essay my friend shared with a clear conscience!