There I waited, in my attending’s empty-walled office, watching lake and mountain images rotate on his desktop monitor, wondering who selects the photos. I thought, Do they know how critical these were to my wellbeing across the last four years? I knew the contours of one such lake well, having scanned it for life many times during this two-week rotation. I liked to play a game in the vein of Where’s Waldo? but for bears and deer. I never saw any.
This rotation was off-site (not at our hospital), at a residential substance treatment center, where my role was seeing patients, treating addiction and psychiatric comorbidities, and observing their group interactions. It was a good experience and notable for the importance of honesty; the more vulnerable the patient was, the more transformative the experience became. I witnessed people make changes, potentially permanent, across that month. I witnessed others retreat to familiar defenses, not getting much from the month.
Upon my attending’s arrival, a formal conversation about my strengths and areas of improvement—a customary conclusion to rotations—was pending and I prepared comments about the parts I enjoyed and would change about the rotation’s design. I’d experienced this process dozens of times, he hundreds of times, and this being my last rotation of residency, senioritis had stripped the usual, squirming anxiety of such sessions into a bare desire for it be over, so that graduation was one day closer (one month away).
My attending was a former supervisor and leader of my residency program. We had worked closely, his mentorship critical in my early development as an intern. I respected his professionalism, commitment, and passion for patient care. He also loved his job, something you can feel if you work alongside someone for long enough. Now at another hospital and not associated with the residency program, this remove and our past relationship, allowed an opening.
One year ago, I knew it, but feared telling a soul, aside from my wife. It was a hard thing to say as graduation neared; I didn’t relish disappointing my family, friends, colleagues, and attendings, who had invested years of time and energy, in me.
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Still there playing my Where’s Waldo? game, the door swung open, my attending gave a quick greeting, then departed from expectation.
“Ryan, you’re a month from graduation and essentially a psychiatrist”, he said, before continuing. “No real feedback here, you’ve demonstrated a lot of growth since intern year, you listen empathically and understand your patients. You’re ready to practice. I’m just curious what your plans are after graduation.”
Sensing he might get it and offer perspective, something I needed, I laid bare my situation (inspired by my patients) to another physician for the first time: “Well, I don’t see myself practicing medicine. I’d like to figure out something else to do with my life. I like this work, at times, but I sense it’s not what I’m supposed to do.”
Without a break in eye contact, he replied, “Everyone deserves a chance to do what they want. I’m really excited for you.”
From someone that loved their job, his comment meant everything. It was vital reassurance. It was an “and then” moment.
I am lucky, chiefly by birth as a US citizen, which increased my odds at that chance. Although deserved, every person will not get that chance, nor will everyone in the US get theirs. I am extraordinarily privileged in my upbringing and educational opportunities, and I consider daily what family and circumstance have provided me. Without these over-the-history-of-humanity jackpots, I would have no “chance”.
A few nights ago, I was listening to Untitled #4 by the Avett Brothers while working on furniture, when another requirement for this chance illuminated: relinquishment. Letting go of what? The song’s lyrics distill it down neatly:
I don’t need to make the world see that I’m not crazy
I don’t need to join in their games
I don’t need to fight to stake my claim
I don’t need the world to know my name
It never mattered if they did
‘Cause I’m happy being me the most
When I let what makes me happy go
And I finally learned what I need to know
I am happier with nothing
What’s the reward for living the song’s ethos? We get to be ourselves, which grants an ability to go after wants. In my experience, I had to earn this part. I had to make sacrifices of acceptance, security, and validation.
Even still, I didn’t immediately know what I wanted, wanted to do, or wanted to be, but I sensed if I kept being myself, relinquishing what was not, that wants would emerge. And they have, thankfully.
Here’s one: I want to share my journey to wholeness because I feel like myself doing it.
And that’s enough for now; a good enough place to start trailblazing. Along the path of doing just that, I live a life I love, something I want others to live too.
(Photo Caption: That “top of summit” feeling, albeit similarly brief, is earned like our chances.)
That was a good attending.
Yes he is. Certainly could have gone another direction (has gone other directions since).