(All newsletters are published first to my Substack, then archived here at a later time. If you’d like to read my writing as soon as it publishes, join my Substack community for free, here.)
- Newsletter #143: Once Begun, Better Finishby Ryan Fightmaster, MDSomething said by Suzanne Rouvier, a character from Somerset Maugham’s The Razor’s Edge, haunts me. A painter’s mistress, Suzanne made a living by posing, and when those artisanal springs stopped flowing, she found the next artist. Living in Paris during the early 1900s, her mix of lanky limbs, fair skin, and bright blue eyes were in … Continue reading Newsletter #143: Once Begun, Better Finish
- Newsletter #140: Fighting the Fevers with Fireby Ryan Fightmaster, MDI’m shivering under a scalding shower, trying to fight the fever with fire. The pyrexic mind is a toxic place, an environment that should never be trusted. But I only know this when my temperature is below 100 degrees. As water pours onto my head and neck, I ruminate on the prospects of my memoir, … Continue reading Newsletter #140: Fighting the Fevers with Fire
- Newsletter #139: Running Hillsby Ryan Fightmaster, MDTo run in Asheville was to run hills. As my neighbor, a cyclist, put it, “I can’t pedal down my driveway without starting a 1000-foot climb.” A plainsmen by birth, I knew the wind, but I knew no incline. Slowly, I adapted, developing a collection of hill-conquering strategies, most of which centered around not looking … Continue reading Newsletter #139: Running Hills
- Newsletter #138: Generational Impacts of One Unlived Lifeby Ryan Fightmaster, MDSunday night, I finished Vivian Gornick’s memoir Fierce Attachments. Reputation warranted. Haven’t been hypnotized like that since the opening credits of The White Lotus. Fear not, there will be no book review, but for our purposes, I will borrow the book’s central question: Can a daughter (Gornick) escape the resentful shadow of her mother’s unlived life? In September of 2022, … Continue reading Newsletter #138: Generational Impacts of One Unlived Life
- Newsletter #137: One Fir’s Dance with Chanceby Ryan Fightmaster, MDSix a.m. My dad’s headlights shine onto my living room’s walls. I down my coffee, lock the doors, and snag my luggage. We’re ski-tripping to Colorado and should be there by late-afternoon, but only if the conditions hold. As the garage door rolls up, I see the driveway’s dusted white. Could get nasty on I-70. … Continue reading Newsletter #137: One Fir’s Dance with Chance
- Newsletter #136: High-Stakes Barefoot Pokerby Ryan Fightmaster, MDFor a year in California, I rented a casita in a family’s backyard. Upsides: fifty-foot pine tree right outside my door, listening to the kids practice piano, only five minutes from the hospital. Downsides: minimal privacy, listening to the kids practice piano, only five minutes from the hospital. As a habit, one I still practice … Continue reading Newsletter #136: High-Stakes Barefoot Poker
- Newsletter #134: Nothing Left on the Lineby Ryan Fightmaster, MDJust past 5 p.m., I was in the garage painting a shelf for our bedroom—the last uncompleted “must complete today” task on my list. If successfully finished, this would mark the first day since our move where I got everything I’d wanted done, done. My mental health was on the line. I rolled the dusky … Continue reading Newsletter #134: Nothing Left on the Line
- Newsletter #133: No GPS Requiredby Ryan Fightmaster, MDVision: seeing things for what they can be, not what they are. – Sam Presti We moved to Oklahoma City for intimacy, not just with our friends and family, but with a place we know. The trade-off—there’s always one—was novelty, I thought. No more surprises at the next bend in the Appalachian highway or amazements at the … Continue reading Newsletter #133: No GPS Required
- Newsletter #132: My Chance to Be at Homeby Ryan Fightmaster, MDIn May of 2023, when my wife and I left California for North Carolina, I hoped Asheville would mirror all of my desires, like an AI chatbot of a city that told me everything I wanted to hear, liked the same things as me, and drank the same beer as me. After eight desperate years in medicine, … Continue reading Newsletter #132: My Chance to Be at Home
- Newsletter #131: Too Happy to Be a Doctorby Ryan Fightmaster, MDThe smell is clinical and familiar. Latex, Purel, steel. Dermatomal maps hang on the wall, to what end, I’m unsure. Maybe the anatomical charts make patients feel better. Maybe they make the doctors feel better, reminding them of their training. Or, more likely, something has to hang on the wall and the maps were cheaper than Thomas … Continue reading Newsletter #131: Too Happy to Be a Doctor
- Newsletter #130: Bewitched by Four O’Clock No Moreby Ryan Fightmaster, MDI have a nasty habit. It’s 4 p.m. Been a good, solid day of work. A clean sweep of the to-do list. Morning earnestness followed by afternoon diligence. At my target of improvement, I’ve stuck my arrow. And if I just tidy up my shop and prepare for the next day, I can glide into … Continue reading Newsletter #130: Bewitched by Four O’Clock No More
- Newsletter #129: How Many Motivational Quotes Does It Take?by Ryan Fightmaster, MDIn the background beyond my laptop, taped and pinned to my office’s wall, are a cadre of motivational quotes. Some in black ink. Some in blue. Some old. Some new. Half from Sam Presti. I rotate them weekly in a starting lineup, switching on mood, season, task, etc. When a quarterback goes to business school, … Continue reading Newsletter #129: How Many Motivational Quotes Does It Take?
- Newsletter #128: Desperation at My Wit’s Endby Ryan Fightmaster, MD“Show him the door,” my attending said, motioning his arms outwardly like an usher. “What do you mean?” I asked. “The patient’s upset with my care. Shouldn’t I try to fix it?” “Have you given him the best care you can?” I nodded. For this patient, I’d emptied the pharmacologic cabinet and fired the therapeutic … Continue reading Newsletter #128: Desperation at My Wit’s End
- Newsletter #127: The Long Sought Failureby Ryan Fightmaster, MD“Hey,” Keti peaked her head inside my office. “You want to take a walk?” I did not want to take a walk. Minutes earlier, the truth had descended into my email with swift brutality. I’d been spazzing refresh for weeks—irresponsibly, repetitively, nonsensically—waiting for word on my application to a local Masters of Fine Arts in … Continue reading Newsletter #127: The Long Sought Failure
- Newsletter #124: Extreme Phone Makeover, Existential Editionby Ryan Fightmaster, MDCocaine or opiates—which one, I cannot recall—dripped by bottle into the cage. Alone, this rat lived in a plastic box with straw bedding, dry food, a water bowl, and drugs. Within hours, the rat began hammering the drug drip like I siphon Diet Lemonade from Chick-fil-A. Shamelessly. Too often. Now addicted, the rat became despondent … Continue reading Newsletter #124: Extreme Phone Makeover, Existential Edition
- Newsletter #123: Out of Equilibrium, Into Bedby Ryan Fightmaster, MDIn my early twenties, I read a self-help book. Named something like the The Happiness Project, The Happiness Revolution, or The Happy Solution. Not a bad read as I remember it, a book that I willfully read not long after turning twenty-one. I find this informative. I remember one of its recommendations: The Breakdown. Scheduled monthly, the author … Continue reading Newsletter #123: Out of Equilibrium, Into Bed
- Newsletter #121: The ROI of Our Pastby Ryan Fightmaster, MD“You poor thing,” said my occupational therapist, a woman in her sixties. Dark brown hair. No makeup. Naturally vibrant. “You didn’t even get to use all those years of school, all that investment of time and money?” She kept cutting straps for my splint, shaking her head. I’d just shared my life story because I … Continue reading Newsletter #121: The ROI of Our Past
- Newsletter #120: A Sterile Field No Moreby Ryan Fightmaster, MDPardon if the punctuation is loose, the memory fuzzed. I had surgery this morning. A small repair to my left hand. Still, midazolam is taking its sweet time through its half-life. I’m blowtorching sentences out of cobwebbed corners. Let us begin and pray the midazolam picks up the metabolic pace. The hardest year of my … Continue reading Newsletter #120: A Sterile Field No More
- Newsletter #119: I Loathe Pumpkins in Augustby Ryan Fightmaster, MD“Seriously?” I said to myself, to my wife, to the ether. I stopped our neighborhood stroll, needing reconciliation. “What?” Keti asked, tone dripping with insinuation. What’s this about to be? We need to cook dinner. “Look,” I pointed at a neighbor’s porch. Barely visible, through the leaves of a verdant maple, was a pumpkin. A … Continue reading Newsletter #119: I Loathe Pumpkins in August
- Newsletter #118: The Sweaty Road to Responsibilityby Ryan Fightmaster, MDThis time last Friday, I was following blood sugars like I used to track meme stocks. By the second. As if my life depended on it. The sugars in question weren’t my own; they belonged to a cabin of fourteen and fifteen year olds, all of which were my responsibility. My week on diabetes camp … Continue reading Newsletter #118: The Sweaty Road to Responsibility
- Newsletter #117: Rinse the Chlorine Off, Repeatby Ryan Fightmaster, MDI didn’t wake up and think, This will be a day I remember forever. I probably woke up and asked my dad to take me to Burger King for a sausage, egg, and cheese Croissan’wich. Because this was summer, this was middle school, this was 2003. Later that night, the setting was suburban. The occasion … Continue reading Newsletter #117: Rinse the Chlorine Off, Repeat
- Newsletter #116: Swings at Eternityby Ryan Fightmaster, MD“Rhyne! Rhyne!” Of the conceivable pronunciations of my four-letter name, this is my favorite. My neighbor Tamara, more Appalachian than “Wagon Wheel” and sweeter than Western Carolina Ice Tea, waived me over from the edge of her above-ground pool. Having just finished my workday in the shop, I walked her direction across our shared greenbelt. … Continue reading Newsletter #116: Swings at Eternity
- Newsletter #115: 1st Class Feats of Unnecessary Athleticismby Ryan Fightmaster, MDMy co-working space is serviceable. I can work, mostly in peace, and the coffee bar deals a rotation of single-origins. Come Friday afternoon, juicy IPAs await in the shared fridge, and overall, the vibes are pleasant. I’ve also made a friend, someone else who works in the space for a few hours each morning. Her … Continue reading Newsletter #115: 1st Class Feats of Unnecessary Athleticism
- Newsletter #114: Nowhere to Hide, At Lastby Ryan Fightmaster, MDThe drive to Children’s Hospital was fifteen minutes, just enough time to forge 90 days of blood sugar readings. Pen in hand, riding in the backseat of my parents’ car, I’d scribble fabrications into my logbook. 132. 289. 71. 320. 97. 120. 62. 205. 110. When my parents would ask their ten-year-old what he was … Continue reading Newsletter #114: Nowhere to Hide, At Last
- Newsletter #113: Remembering the Unforgettableby Ryan Fightmaster, MDOn offer, I try to be useful here. Each week, I want to deliver a payload of helpful perspective. To that end, I can’t afford to get lost on existential errands. But every so often, I find it necessary to unhitch the trailer and drive the damn truck to the top of the nearest mountain … Continue reading Newsletter #113: Remembering the Unforgettable
- Newsletter #112: Only One Way to Find Outby Ryan Fightmaster, MDIt is what it is: I’m a sports guy. Some people appreciate William Blake. Others Tkaikovsky. I have Sam Presti, the Oklahoma City Thunder’s general manager (written about here, here, here). His team, my team, is one win away from their first NBA championship. If I didn’t write about my team again, right now, it … Continue reading Newsletter #112: Only One Way to Find Out
- Newsletter #111: Turn Off the Lightsby Ryan Fightmaster, MDWhile in medicine, I lived—and hunted—across an Alaskan summer. Day or night, I tracked illuminated targets. Guesswork eliminated, I shot well. And ate well. “Why’s that so bad?” you might ask. “Isn’t success what matters? Why not enjoy the sun? Get a nice tan?” If Where The Red Fern Grows—a book representing 100% of my … Continue reading Newsletter #111: Turn Off the Lights
- Newsletter #110: I Owe My Neighbor A Six Packby Ryan Fightmaster, MDI didn’t sleep much last night. Because every time I rolled over, I replayed Haliburton’s pull-up jumpshot hovering in the air for what seemed like a blue-zone lifespan. Again and again, I watched the basketball float and spin and descend, then kiss gently off the rim and through the net. Pacers win. Thunder lose. I … Continue reading Newsletter #110: I Owe My Neighbor A Six Pack
- Newsletter #109: My White Lotus Liberationby Ryan Fightmaster, MDIt’s been a month since I finished White Lotus, Season 3. It’s been a month since I started White Lotus, Season 1. Do the math. Not many days. Many episodes. No regrets. Since, I’ve watched other shows. I’ve also watched enough NBA playoffs to predict when the next commercial will be a Wingstop commercial. But … Continue reading Newsletter #109: My White Lotus Liberation
- Newsletter #109: Everyone Wants to Individuateby Ryan Fightmaster, MDLast week, as discussed, I got a tattoo on my forearm. And I was excited. Then, I went to Oklahoma City for the weekend. Soon enough, I found myself seated on a row amongst my family at my cousin’s high school graduation. I glanced down the row. I saw a lot of forearms. Aside from … Continue reading Newsletter #109: Everyone Wants to Individuate
- Newsletter #108: Whatever It Takes for Workby Ryan Fightmaster, MDFor inspiration, let us look to my tattoo artist’s story. At eighteen—not yet tattooed himself—he walked into a tattoo shop in the Florida town where he grew up and said, “I want a job. I want to be a tattoo artist.” The shop, a bristly biker scene, wasn’t receptive. The owner told him to get … Continue reading Newsletter #108: Whatever It Takes for Work
- Newsletter #107: One Day You’ll Feel Betterby Ryan Fightmaster, MDFirst year of medical school, we were forced to take one humanities course. I chose Medicine and Literature. Our teacher was a retired Dean of Medicine. Bald as a basketball, round spectacled, and perpetually bow-tied, he could enter the room and own your respect without saying a word. Still cycling, he was spryer than us … Continue reading Newsletter #107: One Day You’ll Feel Better
- Newsletter #106: Maybe I’m A Psychoby Ryan Fightmaster, MDBefore the pandemic, my screen time report was respectable. At the gym, I wouldn’t listen to anything at all. Maybe I’m a psycho but it felt better, simpler, to just lift. I often left my phone in the apartment on short errands. No push notifications. I didn’t yet have Twitter. Covid broke me. Well, covid, … Continue reading Newsletter #106: Maybe I’m A Psycho
- Newsletter #105: Unhinged for Good Reasonby Ryan Fightmaster, MDWe all have that one thing we need to be okay. A tidy house. Cardio. Diet Mountain Dew. A washed car. Vanderpump Rules. My thing is sleep. If everything else goes to hell, I’ll be fine. If I’ve had eight hours of sleep. By the end of residency, sleep was my Alamo. The cavalry was … Continue reading Newsletter #105: Unhinged for Good Reason
- Newsletter #104: I Don’t Remember Who Wonby Ryan Fightmaster, MDHits off my leather glove’s scent between pitches. The shortstop yelling “Two down!” to me in centerfield. Me holding up two fingers back. Fescue trimmings and dew covering my cleats. Errors forgotten in the dugout over lagers and laughs. The soft hoot of an owl echoing from the forest beyond the fence. It’s been two … Continue reading Newsletter #104: I Don’t Remember Who Won
- Newsletter #103: The Unquestionedby Ryan Fightmaster, MDMost mornings, I lock my phone into ‘Do Not Disturb’, shun the news, and generally avoid sound. I want unimpeded clarity. I have one shot to set sail with clarity. Because the morning’s tailwind will only last so long. By afternoon, my phone miraculously exits ‘Do Not Disturb’ and news sneaks into my awareness as … Continue reading Newsletter #103: The Unquestioned
- Newsletter #102: Where Capability Meets Its Deathby Ryan Fightmaster, MDUp to a certain point, cans are more valuable than our cannots. An important can from my early adulthood: learning I can be a teacher. I’d never taught anything, but I learned how. From then on, I knew I could do something I’d never done before. This has been a valuable understanding. Though, past a … Continue reading Newsletter #102: Where Capability Meets Its Death
- Newsletter #101: “What Choice?”by Ryan Fightmaster, MDIf you can survive yet another Rounders reference, read on. Mike McDermott (Matt Damon) is standing on the threshold. If he turns around, he’ll become an attorney. If he steps forward, he’ll admit he’s a poker player. At the halfway point of the movie, he still thinks it’s possible to live both lives. And why … Continue reading Newsletter #101: “What Choice?”
- Newsletter #100: The Wrong Turn to Rightby Ryan Fightmaster, MDWhy did I stay inside medicine for so long? Why didn’t I quit after a year? Or two? Or seven? I always knew what I wanted—which was to quit medicine—but I took one wrong turn and kept driving. For eight years. Why?!?!?!? My best guess is that I needed it. I went to medical school … Continue reading Newsletter #100: The Wrong Turn to Right
- Newsletter #99: Where I Use to See Bears, I Saw Shipping Containersby Ryan Fightmaster, MDJiving hip-to-hip with the French Broad River, Amboy Road was my favorite cross-cut through Asheville. A superb scenic route, it had the essentials: views of flowing water, panoramas of an expansive park, trails full of conversing groups, and curiously, an old Nascar short-track converted into an outdoor cycling velodrome. On harder days, ones where I … Continue reading Newsletter #99: Where I Use to See Bears, I Saw Shipping Containers
- Newsletter #98: This Ride Isn’t So Fun Anymoreby Ryan Fightmaster, MDPlease, I just want to live at the tip of the spear again. As the projectile of my life flew through the air, I clung to its trailing feathers. The ride wasn’t fun anymore; it was thrashing. A return to the spear’s tip seemed impossible. So I tried to survive. Once, years before, I’d lived … Continue reading Newsletter #98: This Ride Isn’t So Fun Anymore
- Newsletter #97: To Hell in a Handbasket, or…by Ryan Fightmaster, MDI wrestled my backpack free from under the seat and unzipped its front. My fingers traced the pocket’s compartments, searching for the rounded contour of my AirPods. They found nothing. Except a rock-hard, half-eaten Larabar from trips past. This is gonna be a loooonng cross-country flight. I did have a steaming cup of black coffee … Continue reading Newsletter #97: To Hell in a Handbasket, or…
- Newsletter #96: Honesty is the Howby Ryan Fightmaster, MD“You were a really good psychiatrist; I looked up to you,” she said between margarita sips. “I never would have guessed.” I guzzled half the lager in my right hand, then said, “Appreciate you saying that, really, but I suppose that says something in itself, right?” We chuckled, took a brief stroll down our shared … Continue reading Newsletter #96: Honesty is the How
- Newsletter #95: Not Needing to Shave My Headby Ryan Fightmaster, MDTo become a doctor, it required I study. To study subjects I didn’t want to study, it required I mainline coffee until my right eyelid twitched. To obtain a daily caffeine dose capable of curing ADHD, I became a regular at the city’s coffee shops. Still, come late afternoon, my attention would beg for relief … Continue reading Newsletter #95: Not Needing to Shave My Head
- Newsletter #94: A Legend If I’ve Ever Met Oneby Ryan Fightmaster, MDLast Saturday night, at the tires of a truck driving too fast, we lost a friend and hero: our neighbor’s tuxedo cat, Rainbow Houseboat. That’s one hard-to-live-up-to name—given by the neighbor’s children—but not only was the name lived up to, it was mythologized as legend. One evening, I watched her stalk a herd of eight … Continue reading Newsletter #94: A Legend If I’ve Ever Met One
- Newsletter #93: Do Something. Anything.by Ryan Fightmaster, MDAfter a furniture project finished ahead of schedule Monday, another one fell through entirely on Tuesday. Suddenly, my week was open. Being the end of the month, I didn’t like this freedom one bit; I wanted paid work. Bills were being billed. Savings needed saved. Roth’s needed Roth’d. Inside this time affluence, two paths appeared: … Continue reading Newsletter #93: Do Something. Anything.
- Newsletter #92: Bottom of the Same-Old Holeby Ryan Fightmaster, MDDuring an early session of our work together, my therapist handed me slip of paper printed with Autobiography in 5 Chapters, a poem by Portia Nelson. “How could I do this to myself?” I asked her, ashamed by my recent repeat of a same-old mistake. “I said this would never happen again!” “Just read the … Continue reading Newsletter #92: Bottom of the Same-Old Hole
- Newsletter #91: Bulletproof Boundariesby Ryan Fightmaster, MDI hate conflict; thus, my boundaries have frequently gone unguarded. When someone else is uncomfortable—whether or not I caused their discomfort—I’ve quickly self-sacrificed. Afterward, I feel a tinge of burning resentment because beneath my automatic response, I didn’t really want to help: I had to help. My actions weren’t compassionate; they were compulsive, not to … Continue reading Newsletter #91: Bulletproof Boundaries
- Newsletter #90: Wave or Notby Ryan Fightmaster, MDTo become a surfer, I endured ass-kicking after ass-kicking. Comfortable nowhere, I’d begin my paddle through the breaking waves, seeking safety on the “outside”—the water past where the waves crested. Along this perilous journey, I’d often lose my balance and grip, take a wave to the chin, and find myself buried into the sand. Even … Continue reading Newsletter #90: Wave or Not
- Newsletter #89: No Villain. No Story.by Ryan Fightmaster, MDAs a child, I loved Disney movies… if I could edit them. When watching alone, I always fast-forwarded through the scary scenes: when Cruella De Vil kidnaps the puppies, when the villagers attack the Beast’s castle, when Jabar becomes Genie’s next master. I’d bypass the trepidation, then rejoin when the hero had control again. Turns … Continue reading Newsletter #89: No Villain. No Story.
- Newsletter #88: Ask Not What Life Can Do For You, But…by Ryan Fightmaster, MD“In the mood for some light reading, huh?” my wife asked. I chuckled, glancing at the book in my hands: Man’s Search for Meaning. Nazi death camps. Torture. Existentialism. Nothing better to calm the senses before bed. For those unacquainted, the author, Viktor Frankl, was an Austrian psychiatrist who endured Nazi concentration camps for three … Continue reading Newsletter #88: Ask Not What Life Can Do For You, But…
- Newsletter #87: Righting the Ship with Recklessnessby Ryan Fightmaster, MDIn the throes of the most anxious period of my life—third year of medical school—I left my house at dusk to go mountain biking. It was Sunday night, marking the end of my last day off before six more days in the hospital. I had to ride to survive another week. Mountain biking is hazardous … Continue reading Newsletter #87: Righting the Ship with Recklessness
- Newsletter #86: Seeking Peace At Any Costby Ryan Fightmaster, MDWriting is rarely fun. Running is mostly hellish. Furniture is so vexing that I often want to sledgehammer dressers and coffee tables into mulch. Yet, when the essay is written, the run is complete, and the dresser is lacquered, I feel at peace. On that day, I have done what I needed to do, and … Continue reading Newsletter #86: Seeking Peace At Any Cost
- Newsletter #85: How We Do One Thing Is How We Do Everythingby Ryan Fightmaster, MDIn 2012, I read the Way of the Peaceful Warrior. I still think about its lessons, often daily, and this week, one passage in particular appeared during quiet moments between football and cranberry-sauce-covered gluttony. First though, some context. Dan, the book’s protagonist (and author), is successful. At Cal Berkley in the 60s, he’s an NCAA … Continue reading Newsletter #85: How We Do One Thing Is How We Do Everything
- Newsletter #84: No Dream is Trivialby Ryan Fightmaster, MDThree years ago, I hired a life coach because I was miserable and didn’t want to feel miserable anymore. Together, we completed a litany of self-help exercises, filling notebooks with my audacious dreams and ideas. One such dream was to open a mountain “hiking hut”. Essentially, a bed and breakfast for hikers that enjoy yoga … Continue reading Newsletter #84: No Dream is Trivial
- Newsletter #83: The Movie Review You Never Asked Forby Ryan Fightmaster, MDTuesday night, my wife and I saw Anora in theatres. As a modern Cinderella, Anora is an NYC sex worker who marries the son of a Russian oligarch after the son pays for her professional services. It’s all going to be better now, she thinks. Money. Status. Security. Even… love. To what she’s sought, she … Continue reading Newsletter #83: The Movie Review You Never Asked For
- Newsletter #82: Home is Where You Areby Ryan Fightmaster, MDIn The Daily Pressfield, Stephen Pressfield explores the arch of the hero’s journey. The journey, he writes, starts at home and ends at home. But for us… where’s home? Born and bred, I’m an Oklahoman. In 2018, I moved from Oklahoma for residency in California, but long before I departed for California, Oklahoma ceased being … Continue reading Newsletter #82: Home is Where You Are
- Newsletter #81: Get Better or Get Bitterby Ryan Fightmaster, MDIn the past four years, I’ve experienced two once-in-a-lifetime events: 2020 and Hurricane Helene. I also got married, so make that three once-in-a-lifetimers. Maybe your number is higher than mine. In 2020, life got smaller. Less things mattered. Priorities appeared. I started planning my exit from medicine. In 2022 when my wife and I married, … Continue reading Newsletter #81: Get Better or Get Bitter
- Newsletter #80: Where Dreams Go to Dieby Ryan Fightmaster, MDAs I watched the month, day, and year flow from my pen’s tip, the date’s significance clicked. Interrupting my wife as she journaled next to me in bed, I said, “It’s been two years since I left medicine.” “Wow,” she deadpanned, writing on without pause. That’s how I felt too: indifferent. My new life isn’t … Continue reading Newsletter #80: Where Dreams Go to Die
- Newsletter #79: Asheville – A Nearly Squandered Opportunityby Ryan Fightmaster, MDTwo weeks ago, I pitched an essay to The Asheville Citizen-Times titled “I Hated Asheville Until I Understood Why”. I’d made peace with place, and against all odds—somehow—had come to accept my complicated city. The editor expressed interest, but my word count exceeded the paper’s limit, so I incrementally sheared off words, sentences, and paragraphs. … Continue reading Newsletter #79: Asheville – A Nearly Squandered Opportunity
- CALL TO ACTION: Asheville Needs Helpby Ryan Fightmaster, MDYesterday, over a free lunch at the medical shelter in Asheville, I met a man. He said to my wife and I, “Wow, this is just crazy, huh?” “Yeah, it is,” we offered back, having offered the same reply hundreds of times in as many locations over the past five days since Hurricane Helene ravaged … Continue reading CALL TO ACTION: Asheville Needs Help
- Newsletter #77: The Moment Before Our Big Shotby Ryan Fightmaster, MDDuring the timeout before a big shot, Michael Jordan would tell himself, “I’ve been here before.” Then, Mike would take the big shot. As I type, Hurricane Helene is barreling toward our home in Western Carolina, bringing along a 1000-year flood. My wife and I haven’t experienced a hurricane before, nor twelve inches of rain … Continue reading Newsletter #77: The Moment Before Our Big Shot
- Newsletter #75: Out of My Mindby Ryan Fightmaster, MDThankfully, I wasn’t always this heady. When I was eighteen, I didn’t ask myself if going to the casino was likely to further my search for purpose. No, in any given moment, I did whatever seemed like more fun. Casino in the afternoon? Sure. Volleyball game at midnight? See you then. How about we grab … Continue reading Newsletter #75: Out of My Mind
- Newsletter #74: Deliverance Through Dread (A Tennis Story)by Ryan Fightmaster, MDHesitancy. Apprehension. Misgiving. When we trade in our security, these feelings are our return. What do we do next? Trade our trepidation back in for comfort? Last night, my wife and I watched Jessica Pegula versus Karolina Muchova in the women’s semi-final of the US Open. Two veteran tennis players, both crafty. Pegula, the American, … Continue reading Newsletter #74: Deliverance Through Dread (A Tennis Story)
- Newsletter #72: All the Necessary Ingratiationsby Ryan Fightmaster, MDThe answer to my question—what will I do instead of medicine?—has emerged. Before two years ago, I’d rise from bed, research alternative physician careers, read a self-help book, and go to clinic for nine hours; then, I’d return home and continue where I’d left off in my book. As one might expect, progress was tedious … Continue reading Newsletter #72: All the Necessary Ingratiations
- Newsletter #71: Enduring the Daunting Season Before Usby Ryan Fightmaster, MDI’m in a new season. I didn’t cause this—nor do I control it—but I know I’m somewhere different. And there’s no going back. The season might be new but the process is familiar. These rhythmic changes used to scare me, disorient me, contort me. In the face of each seasonal inner transformation, I felt I … Continue reading Newsletter #71: Enduring the Daunting Season Before Us
- Newsletter #70: Something Beyond Tryingby Ryan Fightmaster, MDUp and down these Blue Ridge Mountains, my wife runs like a hybrid jackrabbit and billy goat, darting through the straights and bounding smoothly through the rocks. Mostly, I watch these efforts from behind as I try my damnest to keep her within sight, only succeeding occasionally. After we finish and I consider heaving somewhere … Continue reading Newsletter #70: Something Beyond Trying
- Newsletter #69: “Where Are You Leading These People?”by Ryan Fightmaster, MDLast Saturday afternoon, I was standing idly on my sidewalk, when a neighbor stopped in front of our mailbox and engaged me in conversation. Our discussion was Ashevillan, featuring commentary on our planet’s consciousness, the need for more manifestation, and a pessimistic assessment of politics. After a year of living here, these conversational themes failed … Continue reading Newsletter #69: “Where Are You Leading These People?”
- Newsletter #68: A Happier Kind of Disheveledby Ryan Fightmaster, MDIn the last semester of my residency, I was chatting with an attending over lunch about one of my patient’s depressions. He was an insightful, smooth, and efficient psychiatrist, in his mid-fifties, and a valuable problem solver in most clinical situations I stumbled into. Yet, other than what I’d observed through our patient interactions, I … Continue reading Newsletter #68: A Happier Kind of Disheveled
- Newsletter #67: Enslaved (or Freed?) by My Catby Ryan Fightmaster, MDWhat is freedom? Where is happiness? Are they my cat’s job? In Freudian ego psychology, happiness is found through autonomy. It’s the ability to sustain one’s own love and nourishment. The target is decreased reliance and increased ego strength. Heinz Kohut believed in autonomy. He lived Freud’s ego psychology dogma, becoming a famed psychoanalyst in … Continue reading Newsletter #67: Enslaved (or Freed?) by My Cat
- Newsletter #66: For the Love of Snow Conesby Ryan Fightmaster, MDMaybe it’s the humidity-wrapped mornings, or the fantasy of finding a pool by afternoon, but I seem to have accidentally found my way into summer’s groove. Thoughts about snow cones are more frequent than thoughts of the upcoming football season, which speaks volumes. Last summer, my wife and I had our European wedding, then moved … Continue reading Newsletter #66: For the Love of Snow Cones
- Newsletter #65: Are Physicians Leaving Medicine? Is There Another Choice?by Ryan Fightmaster, MD“Sometimes it seems like people are getting into medicine to get out of medicine. It is even strange, like the degree is something they have but don’t want to use.” Wednesday morning, I received notification that someone had commented on one of my YouTube videos. I read the comment above and laughed out loud. No … Continue reading Newsletter #65: Are Physicians Leaving Medicine? Is There Another Choice?
- Newsletter #64: Enduring the Dark by Fireflyby Ryan Fightmaster, MDSpirit and soul. Until about twenty-five, I considered the words synonymous, representing the same idea: who we are. But I was wrong. Because until that time, I’d only known my spirit. Enter medical school, the one pursuit my spirit couldn’t lift me through, the place where my spirit sank into darkness, the place where soul … Continue reading Newsletter #64: Enduring the Dark by Firefly
- Newsletter #63: Freedom from All-Encompassing Failureby Ryan Fightmaster, MDForgive me for paraphrasing, but the original video clip has escaped my Google searches. Still, I remember what was said vividly enough to rely on its wisdom daily. It was a relaxing Sunday evening three weeks ago. Earlier in the day, I’d missed the end of the PGA Championship and was hoping to catch the … Continue reading Newsletter #63: Freedom from All-Encompassing Failure
- Newsletter #62: Scared to Remember Your Mission?by Ryan Fightmaster, MDYesterday, I listened to Sam Presti’s end-of-the-season press conference. You will not find another name mentioned as often as Presti’s in these weekly newsletters. Rain or shine, losing or winning season, I cherish listening to that guy talk about my Oklahoma City Thunder. Compared to our recent finishes in the league’s cellar, the 2023-2024 season … Continue reading Newsletter #62: Scared to Remember Your Mission?
- Newsletter #61: An Alternative to the Wrecking Ballby Ryan Fightmaster, MDI hit a wall this week. A big one. By Wednesday night, I was angry. While I was weed-wacking the innocent weeds surrounding the perimeter of my home, I wanted to annihilate them. In a week where it seemed nothing was easy, on a day where the to-do list was kicking my ass, I was … Continue reading Newsletter #61: An Alternative to the Wrecking Ball
- Newsletter #60: Into the Torture Chamberby Ryan Fightmaster, MDDozens of books on mindfulness. A few dozen more on Buddhism. Meditation groups. Meditation retreats. I tried to enlighten my way past my medicine problem. And to the credit of those pursuits, my illusion of self-will (and I) narrowly survived medical school. Dialectical behavioral therapy. Cognitive behavioral therapy. Acceptance and commitment therapy. I mastered and … Continue reading Newsletter #60: Into the Torture Chamber
- Newsletter #59: Forgotten Names and Remembered Resolveby Ryan Fightmaster, MDI like writing because it sifts meaning from the events of my life that would have otherwise flown past. In that way, it’s like therapy. It always surprised me when a singular, seemingly pedestrian event, would become the one thing I wanted to talk about most with my therapist. After the first sixty seconds of … Continue reading Newsletter #59: Forgotten Names and Remembered Resolve
- Newsletter #58: I’m Done Explaining Myselfby Ryan Fightmaster, MDOne of my favorite movies is Hot Tub Time Machine. Once a week—bare minimum—I consider its lessons. The soundtrack is perfect. The jokes are unseemly. The lure of time travel, aimed at reversing a life of regrets, is promising. One time, I convinced my wife to watch it with me. She has since indicated her … Continue reading Newsletter #58: I’m Done Explaining Myself
- Newsletter #57: Playing to an Audience of Oneby Ryan Fightmaster, MDIn The Elements of Style, E.B. White writes, “… the true writer always plays to an audience of one.” This, I believe, is the only viable way to keep our aliveness. For the year or so before I left medicine, I thought daily about quitting. When I gave it serious thought, I felt guilt. How … Continue reading Newsletter #57: Playing to an Audience of One
- Newsletter #56: Pick Up the Weightby Ryan Fightmaster, MDThe hardest aspect of going to the gym isn’t lifting. It’s not the stairmaster. It’s not the pain. The hardest part is picking up the damn weight and getting under the damn bar. And Friday workouts suck the most. My last lift of the week is dumbbell lunges and I hate lunges. Right before those … Continue reading Newsletter #56: Pick Up the Weight
- Newsletter #55: Source Materialby Ryan Fightmaster, MDFrom the time my wife leaves until she walks back through the door, I work in solitude. Save for my daily brushes with the neighborhood cat, woodchuck, and goat, it’s just me and my thoughts, all day. Unless, I get bored and fall inside the entertainment portal in my pocket. I’m mostly safe from its … Continue reading Newsletter #55: Source Material
- Newsletter #54: Earning Your Answersby Ryan Fightmaster, MDWorking on furniture has done more good for my perfectionism than anything else, aside from therapy. Every afternoon, rain or shine, whether I have the necessary supplies or not, I have to figure out the next step. I must get the piece to market. It would appear that I work on furniture. But at any … Continue reading Newsletter #54: Earning Your Answers
- Newsletter #53: Do Not Disturb the Great Whitesby Ryan Fightmaster, MDThe nearest surf spot to our house in Santa Barbara was a point break called Leadbetter. That place terrified me. In South Orange County, I’d surfed sandbar beach breaks, which accommodated my falls with minor inconvenience. At Leadbetter, my skull could crack open on its rocky bottom. And of course, as always, there were rumors … Continue reading Newsletter #53: Do Not Disturb the Great Whites
- Newsletter #52: Go Be Youby Ryan Fightmaster, MDFour months ago, when I leased a booth to feature my furniture, I knew nothing about retail. To get the booth open, I imitated the successful shops around my space, coloring my walls dark because their booths were dark, painting my floor gray because their floor’s were gray. As I spent that first week painting … Continue reading Newsletter #52: Go Be You
- Newsletter #51: Thanks for Being Honestby Ryan Fightmaster, MDThis week, two different strangers thanked me for being honest. The first conversation happened inside the furniture store where my wife and I rent space. Two stalls down, I saw a woman I hadn’t yet met, and introduced myself. Eventually, after sharing her tricks of the furniture trade, she asked what I used to do. … Continue reading Newsletter #51: Thanks for Being Honest
- Newsletter #50: The Honeymoon’s Overby Ryan Fightmaster, MDFor those first three months after I left medicine, it was bliss. To exist, each day upon awakening, was to be outside of medicine and that’s all I needed to be fulfilled. For so long I’d worked for that feeling: to just not be a doctor. Everything was rapture. Beer tasted great again! I liked … Continue reading Newsletter #50: The Honeymoon’s Over
- Newsletter #49: Life’s Too Short to Drink Teaby Ryan Fightmaster, MDFor a decade, I’ve made coffee by the pourover method. For those first nine years, I managed to make a few good cups of coffee. Without a scale, without an understanding of water to coffee ratios, without an assessment of the grounds’ coarseness, and without a measure of the water’s temperature, I’d use my judgement … Continue reading Newsletter #49: Life’s Too Short to Drink Tea
- Newsletter #48: Winter’s Getting to Meby Ryan Fightmaster, MDYesterday, on my morning walk by the creek that trickles behind our home, a purple speck caught my attention. Because I was looking for trout—something I do no matter the depth of the creek, river, or lake—I saw the color pop against the brown dirt of the creek’s bank. With cold hands, I scattered decaying … Continue reading Newsletter #48: Winter’s Getting to Me
- Newsletter #47: Like It or Not, This Will Serve Usby Ryan Fightmaster, MDIt’s remarkable how often I find myself thinking back. I know I’m supposed to be present. I know the answers are here and now. But more and more, I believe my past is the handhold to my future. For instance, I was ready to quit residency five months before graduation. I was so ready to … Continue reading Newsletter #47: Like It or Not, This Will Serve Us
- Newsletter #46: To Forget Is To Earn Alivenessby Ryan Fightmaster, MDI’ve read enough by now to know that this is the best of times. The grind. The way-finding. The devotion. This is what people wish they could go back and relive. I’ve also lived enough by now to know why this is the best of times. The compromise. The misery. The disintegration. That. I don’t … Continue reading Newsletter #46: To Forget Is To Earn Aliveness
- Newsletter #45: Looking the World In the Eyeby Ryan Fightmaster, MDThree years ago, on a redeye flight from Oklahoma City to Orange County, I witnessed a flight attendant work with such grace, presence, and self-possession that I wanted to ask how he found enlightenment. It was obvious he loved his job and he wanted to be there. Something in the service of drinks connected him … Continue reading Newsletter #45: Looking the World In the Eye
- Newsletter #44: The Coffee Ain’t For Meby Ryan Fightmaster, MDFor the third consecutive Wednesday, I went to my local coffee shop to write. As I sat, staring out the shop’s window into a grocery store parking lot, listening to the ladies next to me discuss the merits of whether the kids should be forced to wait at the bus stop when it’s less than … Continue reading Newsletter #44: The Coffee Ain’t For Me
- Newsletter #43: I Cannot Be Trustedby Ryan Fightmaster, MDPublic opinion sees chewing on fingernails as slovenly. Something an unkempt person would do. As one of the unfortunates to be afflicted with this chronic behavior, I disagree. I chew my cuticles and nails down because I cannot tolerate the disorder. If one cuticle so much as thinks about lifting away from its nailbed, my … Continue reading Newsletter #43: I Cannot Be Trusted
- Newsletter #42: The Power of a New Identityby Ryan Fightmaster, MDI used to craft a list of goals on January 1st. From 2014 to 2021, I was a zealot, dedicating hours and hours to this alter. My goal sheet had three columns: 1 year, 5 year, and 10 year. The idea came from a productivity book. And to the exercise’s credit, I accomplished a few … Continue reading Newsletter #42: The Power of a New Identity
- Newsletter #41: Even Better Than Hampton Inn’s Breakfastby Ryan Fightmaster, MDThis week I worked from Tampa Bay. Or St. Petersburg. Or Clearwater. Or Largo. Somewhere in the more tropical, more relaxed, still sprawling east coast that mirrors the sprawling west coast I know well. Allegiant offered a $117, round-trip chance to accompany my wife to her conference, and I said, “Bye winter.” On our last … Continue reading Newsletter #41: Even Better Than Hampton Inn’s Breakfast
- Newsletter #40: Where We Must Never Compromiseby Ryan Fightmaster, MDI love The Razor’s Edge by W. Somerset Maugham, especially the book’s introduction. The passage opens with a quote: The sharp edge of a razor is difficult to pass over; thus the wise say the path to Salvation is hard. – from the Katha Upanishad Maugham, a prominent novelist of the 1900s (and interestingly, a … Continue reading Newsletter #40: Where We Must Never Compromise
- Newsletter #39: Just Punt the Damn Ballby Ryan Fightmaster, MDFor those unacquainted, field position is a football thing. The idea is to dictate where the ball is located on the field. If you can keep the other team further from your endzone, they won’t score as many points. And if they don’t score points, you usually win. Ask Iowa, they make football scores look … Continue reading Newsletter #39: Just Punt the Damn Ball
- Newsletter #38: Save a Mouse To Save Myselfby Ryan Fightmaster, MDToday, I stood at my stove cooking an egg sandwich—the best form of sandwich— when through our window I caught a strange scene. Our neighbor’s cat had a mouse trapped, bopping it around the yard with its paws. The mouse would run, the cat would chase, and just as the mouse was close to its … Continue reading Newsletter #38: Save a Mouse To Save Myself
- Newsletter #37: Close Out Your Tabby Ryan Fightmaster, MDAgreeability has been my modus operandi in interpersonal relationships. Get on with it Ryan. It’ll be fine. It’s not a big deal anyway. These rationalizations serve to soothe over my compromise until it seems I never transgressed at all, and even more, at least for a while, it seems everything will be fine. But every … Continue reading Newsletter #37: Close Out Your Tab
