Last night, I met with my former co-residents on Zoom. We discussed a recently published study on the connection between early psychiatric diagnoses and the development of cardiometabolic conditions. Once a quarter, this is what we do, and I try to never miss a meeting.
As our meeting wrapped, and we all caught up, a friend and former co-resident asked, “So… Ryan… why are you here again?” She grinned warmly as she puzzled the question, hinting at the irony of my presence. I, after all, had not practiced psychiatry for nearly two years and just spent my evening discussing the practice of psychiatry with a group of psychiatrists who are practicing psychiatry. One person, indeed, did not look like the others.
“Well, for one, I do enjoy seeing y’all.” Before furthering my explanation, I was ridiculed for using the southern colloquialism, a habit acquired since jettisoning California for Carolina. When the jeers subsided, I started again, “I think these get-togethers help me stay in touch with the parts of me that did really enjoy being a psychiatrist.”
“Seems like you’re trying to live in the grey,” my co-resident summarized.
“You know… I think I have to.”
As the days turned to weeks, building to that first year after I resigned, I really wanted to leave medicine by the curb. It was, as I thought, all boxed up and contained, readied for donation to Goodwill. It was all just a sunk cost, right? Just an eight-year period where I was inauthentic, right? Just a reminder of the price for compromising my soul, right?
Then, I went back to Orange County—home of my psychiatry residency training—for a best friend and former co-resident’s wedding. And there, I realized what I’d stand to lose if I left medicine behind: myself. Everywhere I looked, I sensed parts of my soul, a tangible feeling of knowing who I was, which diverged from my growing desire to categorize medicine as one colossal failure. That categorization couldn’t stand up unless I disregarded the experience before me.
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With every day of the year that’s passed since that trip, I’ve watched integral parts of who I am grow from the medicine ashes—once willfully forgotten, but now ready to be seized and carried forward on my lapel. What’s more humbling, I find myself wanting to carry those flowers forward. If I were to leave it all behind, I don’t know who would be left to keep walking forward. It meant too much… because it made me.
About a year ago, I met with my therapist for one our last sessions together before my wife and I moved to Carolina. As I mourned the end of our work together, I sensed immense loss. It seemed, not just in the relationship with my therapist, but in my move away from California that I was losing something I’d never be able to get back, something irretrievable. I was saying goodbye to medicine—and California—forever. Yet, in her habit of delivering keen insights just beyond the veil of my present understanding, my therapist said, “Ryan, I hope you understand that all of this will live in you forever, that a part of California will always be in you.” I hoped she was right, but as my wife and I drove east on I-40, crossing the California state line into Arizona, all I saw were California and medicine disappearing from my rearview mirror, feeling nothing as the miles gathered between us.
Her insight needed time. I just needed to make it to now, where I understand that I can’t fully be who I am without being a physician, nor can I fully be a physician while being who I am. Exactly what that means, I’m not sure. It is what it is, and wherever it leads, I’ll need everything that’s made me who I am, if I hope to survive inside the grey.
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