A duplex has risen, across the street and through my office window; a transformation from clay, to concrete, to wood, and now, to rent, is almost complete.
In this witnessing, I’ve heard more than I’ve seen. Lots of nail gun. Lots of table saw. Lots of laughs from the workers. Today, an ambient hum rings through my office, curiosity rousing me to look the duplex’s way, again, where I see a truck pumping foam ventilation into the structure’s walls. It’s good-looking too, wrapped in a two-tone, grey-navy siding and two-storied with west facing windows. Closer to livability by the day, I’m excited to see the finished product (and for the table saw to stop).
Though, I wonder about its foundation. I hope its stable, self-assured, rooted. (Wait, are we still talking about construction?) Because I once owned a good-looking home, constructed with attention and dedication, but the foundation was shit, and it sunk right into the hole from which it came.
This previous home, lost to a sinkhole, was my life in medicine, as you guessed.
The appraiser—yes, this analogy has an appraiser too—would have assessed my home, before collapse, positively:
In a nice neighborhood, the home boasts walk-in closets, a heated pool, and turrets on steepled sections of the roof. The public school system is fine but doesn’t matter, because all the kids go to private school. On resale, appreciation is guaranteed. Any foundational issues can be fixed with money; there are cracks, sure, but in this neighborhood, everything is fixable, again, with more money.
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Since collapse, I was forced into another construction, of a new home. The same appraiser was so kind to offer another judgment:
This home won’t appraise for much. One room, with a mattress on the floor, one burner stovetop, and a wooden desk in the corner. One window. Under a tin roof, everything arranged and clean though. No homes nearby. In the woods. No additive value from the neighborhood. Kids are bussing to public school. Appreciation subject to growth of home and area. Foundation intact and deep, perhaps as deep as the home stands tall.
After, I get to talking with the appraiser about these homes and my lot in life. “Interesting place to live now”, he says, with subtle insinuation that I got the short-end of the stick. “Why would you choose to live here?”
“Because once, I lived in that first home”, I say, pausing now to pull from my cigarette, before exhaling, less for smoke release and more to build anticipation. “And the foundation’s better here.”
(For drama, I smoke in the analogy.)
“Whatever you say,” he answers, shaking his head as he gets into his car, throwing dust at my shack. Unfazed, I let loose my grip from the cigarette and stomp it out in the red dirt, then step through the threshold into my new home, settle into my chair, and ready for work at my desk.
What I do here, every day, is different than what I did before, for a simple reason: I’m operating from a vision of who I want to be, which pours a foundation I never used to have.

Before, the house was going up around me as I tried to insert myself, see myself, in the designs. If I built it bigger, would it feel like home? What about another beam across the ceiling? Bet that’ll shore things up. Would a lambo in the garage help? How about three?
I wanted to make that house work. And my rationalizations had me convinced, for years, that it might just be a good home:
- What other job can I make $200,000 while working 3 days a week?
- I do love helping people, so this is a meaningful life, right?
- What faster way can I possibly pay back student loans than this?
But rationalizations are not understandings. They’re coverups and retrofits. At the foundation, I went into medicine because I didn’t know what else to do. I was scared to figure out what I wanted to do. Scared of that responsibility. And through medical school, residency, and a board certification in psychiatry, I was afforded a beautiful lesson:
Fear and rationalization aren’t how you build a house.
The ground where my house is built, now, was well-surveyed. When the cement was poured, onto packed clay, reinforced by rebar, and out of a flood zone, I was precise. Had to be, this is my house now. If a tornado wipes it out, I’m rebuilding here because the foundation is good. Over and over, I will place brick upon brick from who I am and what I trust is right, which will surely bring mistakes—ones I’m privileged to get to own. And progress is going to be laboriously tedious, much slower than the duplex across the street. I don’t expect turrets back on the roof again for a while. But I know, if I do this right, at least I’ll be in the house. Still standing. Still working. Still myself. Foundation locked in place.
Because what’s the point otherwise? A nice house, without me inside it, isn’t a house at all.
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