Our brains are sense-making machines. If it does not make sense, we make it make sense.
I get it; leaving a career that offers the security of a six figure paycheck is mystifying. At this mystification, my friends and family have tried to guess why I left, to understand why someone would exit an eight-year, $250,000 investment.
I have received many guesses in the past month. Before breaking down the real reason I left medicine, below is a ranking by frequency of the reasons people assume I left physicianhood.
Reason #1: “It has to be emotionally draining seeing psychiatric patients all day”
That it is, no arguments here, but it is also immensely meaningful work. The meaning tends to balance the emotional toll, if you manage to keep it about the patient and understand your own reactions. Undergoing my own weekly therapy made this doable. Of all the specialties in medicine, psychiatry was the most suited to what I enjoy: relationships.
The field of psychiatry was not the reason I left medicine.
Reason #2: “You probably need a break after all that education”
Eight years is a long time. At the conclusion of residency, I would advise taking time off. Go to Thailand. Go spend a month with your grandparents. Do all the things you put off. I took six weeks off, sleeping 9 hours a night and napping every afternoon. When I went back to clinic, none of it mattered.
A break was not going to fix my problem. I have taken many vacations, including ski trips in the Rockies and Costa Rican surf camps. The vacations were just escapes.
Fatigue was not the reason I left medicine.
Reason #3: “You’re burned out. Healthcare is broken.”
Yes, healthcare has turned into a treadmill of tasks eating away at the physician’s time with patients. Did I experience burnout? Of course. But at the end of the day, when you don’t want something, it’s hard to suffer on behalf of that something. If you took away all pages, prior authorizations, prescription refills, and calls from the pharmacy, I would have ended up “burned out”.
Burnout was not the reason I left medicine.
I left medicine because I had to know.
What did I need to know? I had to know if I could do it. What was it?
In my favorite movie Rounders, Matt Damon’s character Mike McDermott is explaining to his mentor Joey Knish, played by John Turturro, his reasoning behind sitting down against World Series of Poker champion Johnny Chan at the Taj Mahal casino in Jersey. His explanation is simple, “…I had to know”. Against Johnny, he wins a high stakes game of poker with “rags” and uses this as a basis of competence to pursue his dream.
Before I went to medical school, I had a dream of living in the mountains, working the ski lift by winter and being a bike mechanic by summer. Why? It sounded exciting to my early twenty’s self. Instead, I went to medical school, because I was scared. Scared to fail. Scared to succeed. Scared to be me. I played it safe and avoided Johnny Chan’s table.
I no longer care to work the ski lift or on bikes—you cannot step in the same river twice—but for what that dream represented I have an intense interest. The dream represented an attempt to figure out who I was and what I wanted.
This I know: I love to build things, I love to write, I love business, and I love strategy. There is something out there, that I will do with all I have, and I will love it. As one of my former attending physicians told me, “Everyone deserves a chance to go do what they want.”
I have to know. I need a chance to figure it out.
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