Since 2024, my writing has appeared exclusively on Substack. Read everything new here.
A Cat Story: Why We Take the Leap of Faith
Healing is possible with time, sure, but healing takes something far more perilous: a leap of faith. But damn, if life’s taught me anything, that risk is nothing compared to its rewards.
CALL TO ACTION: Asheville Needs Help
Yesterday, 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…
25 Years Later, I Accept My Type 1 Diabetes Diagnosis
As Kohut said, it’s not in absolute autonomy that we find ourselves, but in healthy interdependence. Same goes for my relationship with diabetes, something I could never understand while in denial, but only through acceptance. And of course,…
No, Really. I Want to Be Here.
“Look at Dr. Fightmaster over there. He doesn’t even want to be a psychiatrist.” I froze. I’d been found out. Then, a wave of fidelity crested and overcame years of hiding, as I replied, “You’re right; I don’t…
Can’t Live With It, Can’t Live Without It
I thought it best to leave medicine behind me. It was just an eight year chapter that I wished to never repeat, right? Two years of time has revealed a surprising opposite: I can’t survive without it.
A 35-Year-Old Man Completes Adolescence
Just because you leave an adolescent age (and enter medical school… and become a doctor… then become a psychiatrist), doesn’t mean adolescence leaves you. Or so I’ve lived and understood, only now, at 35 years old.
The Eternal Impact of One Choice
As I followed these footsteps, my family members didn’t turn around and implore me to take notes. Still, their bravery planted seeds of potential within my heart, and subsequently, I took copious notes. They did what needed to…
A First in Many Moons—The Hunt Stops
For the past eight years, I’ve been afraid to pause, scared to rest, reticent to enjoy. Unconsciously, I knew I couldn’t take that risk. But now, I consciously know I must.
What Does It Mean to Lose?
Failure. Absolute dejection. That’s how I classified every loss. Until, that is, I needed to adopt another way to play the game… to be happy.
We Self-Deceive to Survive
It’s impossible to understand why we’re doing anything we do. When we do arrive at this future clairvoyance, we’ll be strong enough to understand; until then, the truth’s weight is unbearable. This week, I arrived at one of…
Written in the Stars: Psychiatry and Me
I’m a psychiatrist. Every so often, whether I’m walking along the stream in our neighborhood, drinking freshly poured-over coffee, or watching sports, this fact enters my awareness. Even now, six years after committing to become a shrink, it…
Infinite Reflections in Medicine’s Mirror
My poor wife. If I utter the phrase “object relations” to her one more time, she may combust. I don’t want that. The same revulsion applies, per her indications, to any mention of Bion, Winnicott, and Klein, the…
How Little Everything Else Matters
My self. Once it was lost, I was willing to sacrifice everything to get it back. And good thing too, because everything was always the price.
All My Whys Were Lies
Life was “… not so clear to me as I have for a long time imagined.” Thanks to Rousseau, I’ve seen my motivations for what they are: obscured by the lies of my whys… until I’m ready to…
The Hardest Gift to Give
I went to medical school to keep my family’s love. Becoming a psychiatrist expanded my understanding of what love is. I needed to leave medicine to practice true love.
A Lit Match Away from Internal Combustion
I’d forgotten this night. My plane touched down in Denver a little past ten, a direct flight from Orange County. I’d watched Southwest’s in-flight entertainment for the duration, seeking decompression. My day had been a long one. Leaving…
The Betrayal, The Regret, The Wholeness: Deliverance by The Devil Wears Prada
The only way to live a life without regret is to have regret. Regret is only the beginning of our story.
Humbled by an Afternoon of Mystery
“Isn’t this world a mysterious place?” I nodded, smiling back at her in agreement. Just an hour earlier, I sold a dresser to this kind woman, and while I was situating her newly acquired centerpiece into her dining…
Wield the Power of No
At recess, I didn’t like the jungle gym or its imaginary castle games. The monkey bars were boring. I could always get down with the swings—everyone loves the swings—but the jungle gym wasn’t my scene. So, every day,…
The Cost of Admission
Watching sunlight spread slowly over my yard’s newly green grass, I accompanied the morning from my porch. It’s a simple, majestic experience, usually. Sometimes I’m lost in thought, worried about this or that, and I miss it; but…
Before I Learned How Much I Needed to Change
“Fighty, we’re all on the long road back to who we were in high school.” I’ve been sixteen, a football player that blasted rap music from his truck with twenty-inch rims. I’ve been twenty-four, a health teacher and…
Sensing, Before Seeing, the Destination
Yesterday as the sun set, I followed GPS directions into a neighborhood tucked between creases of the Blue Ridge Mountains. I instantly adored the place. At the neighborhood’s entrance, there was an empty pond with wooden docks for…
Give Me Risk, or Give Me Death
I can’t remember the podcast or the person that said it, but I heard this week that people in the United States are living at the lowest levels of risk since our country’s inception. Why risk it for…
Where the Story Starts
As I walked their trails in my old shoes, it occurred to me that I had no idea, then, how meaningful those years were. I had no sense that a lesson was coming. I was operating under no…
‘No Trespassing’
I simply cannot afford to be cruel to myself any longer, a holdover from my survival in medicine, and hope to create a life I love.
In the Truthful Places
Toward the end our celebratory dinner, my grandpa made eye contact with me and from across the table, mouthed, “I’m so proud of you.” I mouthed back, “Thank you Gramps.” But I was not proud of me. For…
A Lesson in Astrocartography
The rise, demise, and return of my love for the local health food store, as told through one flyer for astrocartography services.
I’d Rather Be Tired Than Asleep
Snoozing is harmless. Everyone snoozes, I thought to myself, when I chose to snooze today. After all, it’s only nine minutes. But nine minutes matters. Ask my throbbing ankle.
The Planet Fitness Portal Opens
Ever experienced inverse déjà vu? I did this week. For me, it’s been about as rare as seeing a bald eagle. Inverse déjà vu, I believe, is a marker on the map of our life, letting us know…
Hello, Happiness? Is That You?
Am I happy? Since my eyes opened four hours ago, I’ve dreaded writing this essay. Now that I’m drafting this essay, the dread grows. It’s not coming together as expected. This feeling sucks. My head hurts. I want…
If It’s Reasonable, It’s A Lie
To really change, I don’t think it’s possible without hitting rock bottom. For me, it was imperative. I needed a humbling. I needed to feel the earth beneath my bare skin. I needed to lose everything. From rock…
The Treacherous Trail to Asheville
People ask my wife and I why we moved to Asheville. Often, we haven’t had an explanation other than it felt right. Often, I do think we’re kinda crazy. But last night, I felt a little less crazy…
“Ryan, You Sure Have It All Figured Out, Huh?”
One finding, revealed as a mid-life crisis, career catharsis, and cross-country move stripped my life to the studs, has freed me from the straitjacket I’ve known for most of my life.
My Reckoning With a Lost Decade
Don’t worry about me, I have no strip clubbing to purge from my system, no “legs and eggs” brunches calling my name; but I do own another desire, one I neglected a decade ago, that I reckon with…
Two Sides of the Same Delusion
Seriously, you’re trying to make $50 off a coffee table? You have $200,000 in student loans! Wake the hell up! This isn’t going anywhere!
One Night of Karaoke Deliverance
My wife and I flew back to Oklahoma City for Thanksgiving, getting in Wednesday afternoon. And four hours after our arrival, we went to a karaoke bar. Not my first choice, but we were with my in-laws. They…
Life in the Land of Consequence
On this new brink, it seems I can’t go a day without making a trade. No matter what choice I make, I have to sacrifice something I want. It wasn’t always this way, but again with the flip…
How Can I Live If I’m Not “Good At Everything”?
Some days, I can bear myself with grace. Other days, I crucify myself for not being good enough, wondering if I should pull the pin and get back to something I’m better at. How I live out this…
Escaping a Cold Prison of My Own Making
Minutes ago, I almost started this essay, but didn’t know what to write, so I procrastinated. God, the muses, and the universe took offense to my inaction and gifted me with my predicament, after I stepped across our…
Lay With Gators to Live With Gravitas
Hours after I quit medicine, the great probe began with a question I’d go on to receive a hundred more times over the next year: “So, what are you going to do now?”
The Peril and Promise of a Rolled-Down Window
I opened my eyes, looked around my parents’ yard, and realized in an instant, what I hoped to never see: five years were gone, and I wasn’t home.
The Truth in a Thousand-Yard Stare
I recently devoured The House of God. What a book, outlining the fictional intern year of Dr. Roy G. Basch, which makes one think about the empty promises of medicine. It makes one wonder if it was worth…
If No One Sees the Leaves Drop, Is It Really Fall?
I saw an endless carpet of blackjack oaks and cedars, dotted in randomly symmetric yellow foliage. The sun wasn’t high enough to burn my retinas, fuzzed by the horizon’s humidity, so I got greedy and gazed as far…
Home Is Where The Dark Is
In time, I would get what she meant. And in time, I would feel the same way she did. But in even more time, I would love the hell out of that place.
Get the Fork Out of the Garbage Disposal
Ryan, if you go become a doctor, you can keep your soul. It’ll work out, always does.
The Only Thing Better Than Sex (Maybe)
I expected victory—sure, we’re the University of Oklahoma—but existential questions I did not expect. Then, I watched this epiphanizing play.
Surviving a 12 Round Backyard Fight to the Death
A younger me would have picked up compromise’s call. Today, I called bullshit, letting it ring off the hook.
You Can Take the Man Out of Medicine
“Hey man, how the hell are ya?” I said. Just another day among normal days. “So, you did it huh?” Ben said, skipping normality. “I’m happy for you, really, but you know the hard part’s coming, right?”
The Secret Sauce of a Great Burger
“You can always leave,” Bryce said, piercing eyes shifting from players to me, “because man, life’s too short to get stuck doing shit you hate.”
What’s Your Life Built Upon? (It Kinda Matters)
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.
Fighting for the Most Sacred Thing We Have
I just missed the enjoyment of normal things. I knew it was gone, knew the coffee didn’t taste as good, and knew the sunsets didn’t hit like they used to.
The “Best of Both Worlds” is No World For Me
One year ago, I started my dream job in medicine; a fruition that transformed from godsend to breaking point to deliverance within weeks.
This Is Harder Than I Thought (Thankfully)
If not for intrepid fantasies of success, I may not have done this. My ego had a stake in the outcome, no matter my pleas for a focus on process, growing, and learning. Ten months ago, I pulled…
Five Hard Lessons in Two Cross-Country Moves (This Year)
This move was objectively harder. Longer. More expensive. But that’s the difference; when you want it, you can suffer more.
A Headhunter’s Offer (And Chicken Exit for the Soul)
I turned for a rapid snooze of my alarm and opened this text. I scanned it with interest. The text was an urgent call from comfort.
What I Must Never Forget (And Why It’s Tattooed On My Forearm)
his commentary made me glance in search of my own tattoo, coming into view from under by cuffed button down as I reached out with my left hand to accept my margarita. There it was; two words that…
Why I Became A Psychiatrist (Really)
“So, why did you decide to be a psychiatrist?” My reply was crisp: “People.” The real reason? I was compelled like iron filings to the magnet.
To Leave California, I Had To Love It First
California, by way of being itself, demanded I make a choice. And it revealed what I must be responsible for: my own deliverance.
Why I Stopped Being Vegan (Because I Wanted to Be Myself)
I went vegan in the spring of 2013, and needed it, for many reasons. It was a five-year, cherished season, until it stood between me and myself.
Life Begins When You Get Off the Treadmill
I could feel my fifty-year-old self doing the exact same things, asking the exact same questions, and feeling the exact same frustrations. Treadmill livin’.
If I Never Wanted to Be a Doctor, What Did (Do) I Want?
Knowing I never wanted (granted, probably needed) to become a doctor—declared given eight years of ample evidence—I must have wanted something else.
Who Is This For?
Two “good IPA”s into an empty stomach, I spilled the beans in search of a palm reading, because I desperately needed clarity.
“Everyone Deserves A Chance to Do What They Want”
“Everyone deserves a chance to do what they want.” From someone that loved their job, his comment meant everything. It was vital reassurance.
One Year to the Day, I Reflect on the Morning My Life Changed
One year ago, I began. It wasn’t this, but it was something, anything. Tired of the charade and sick of waiting, life or death hinged on my actions on 3/20/22.
How to Choose Happiness When It’s Not What You’ve Lived
When I resigned from medicine, I figured the war was decisively over, that fear would surrender and providence would be mine. How mistaken I was.
When It Rains, It Implores (How To Survive Any Storm)
As I ventured through seasons of burnout and depression, I couldn’t forget that sunny memory in my soul. If I knew it once, I’ll know it again.
Fear and Soul Play A Game of Poker (aka The Last 8 Years of My Life)
Still, gambling is a story I get—stakes and pots, calls and folds, all-in’s and gone busts—because once upon a time, I refused to go all-in and still went bust.
The Vice and Virtue of Being the Nice Guy
“That Ryan Fightmaster, he’s such a nice kid.” “That Dr. Fightmaster, he’s just so nice.” I built my life upon these comments. I sung a tune targeting those praises. Being the nice guy was my compass, goalpost, and…
An Uncomfortable Reality—I Needed Those Depressions
I made it 28 years before the first depression. It was a good run. The darkness descended spring semester of my third year of medical school, the hardest year by my count.
The Gift of Quitting Medicine (I Got My Life Back)
Santa Barbara’s southern orientation and point breaks offer a surfing delight: no current. Currents were a part of the game in Orange County. I’d paddle out close to where the wave broke, bookmark my place on the horizon…
So… What’s Next for Me?
This one’s more of a journal entry—not a knowing but a figuring—because the truth is this: I don’t know what’s next.
What I Know About Regrets
“Ask yourself”, my ninth-grade football coach called through the evening roar of early autumn secadas, “Have I emptied the tank today?” He’d ask the question with one “gasser” left in the conditioning portion of practice; sun already set,…
Would I Still Go to Medical School?
If you could go back to the few months before starting medical school, with what you know now, would you still do it?
Anxiety’s Surprising (And Unlocking) Opposite
But, there’s a distinction worth noting: we cannot control our thoughts. Yes, we can reframe our thoughts and test cognitive distortions—an invaluable practice—but the original thought is out of our purview.
A Letter To My 25-Year-Old Self
I do not wish to be 25 again—changing the past is a drug I’ve kicked—but I wish to make amends with that part of me that lost what I again hold now: hope. I write this letter for…
What Surfing Couldn’t Cure (Me)
Surfing was the vanguard of my soul. It stood in opposition to medicine’s relentless capitulation. It was my last stand… and it wasn’t enough.
Are You Burned Out Or On The Wrong Path?
The true litmus distinguishing burnout and the wrong path is… I don’t know. You just feel it. I knew I was on the wrong path but had to try every source of power located externally before realizing I…
Why I Stayed (What I Loved As A Physician)
I resigned Thursday September 22nd, 2022. After a ten-minute walk to the post office, I dropped the envelope in the metal box and meandered home, wondering, Did I really just do that? The response from within was immediate:…
The 3 Reasons People Go to Medical School… And My Reason
It was the spring semester. Being first year, medical school had novelty, excitement; eyes twinkled in the hallways. We were all figuring this out, and closing in on one year in the books. “No small feat”, we thought…
The Art of Churning (How I Made the Leap Out of Medicine)
Our life is a ship, sailing through the seas of experience. When we make a decision of consequence, our mind creates a parallel “other ship” sailing alongside—a means to keep alive our “what if”s and “could’ve been”s. No…
The Best BS Detector Experience Can Buy: The Bar Introduction Test
A passing score occurs when you get excited talking about what you do and they ask a follow-up question. A passing score is dynamic and connecting. After sharing, you’re ready to hear what they do.
Fractured Living: The Cost of Taking The Path More Traveled
A choice presented itself: go to medical school or follow my soul where it led. Below the surface, the choice distilled further: choose fear or choose life.
The Real Reason I Quit Medicine
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…
My Sage and Mentor—A Squirrel with No Tail Modeled My Dreams
This is where I found myself, back in the fall of 2021. Not seeking ways to improve my situation. Interested mostly in ways to change the past and ways to numb the present. But I was growing tired…
A Game of Softball Led Me Out of Medicine
Competition is critical; not for the ego-notched victories but for the learning opportunities. The insights made available through sport are not as clear in our day-to-day, but once we’ve felt it in competition, we get to take it…
A Report from the After-Medicine Wilderness
Now, I do not wish to be kept warm, thinking that “it’ll just work out” or “I’ll figure it out tomorrow”, because even here inside fear, sleepless nights, and endless uncertainty, it is so much better than it…
When You’re Stuck, Do This
I have learned a critical truth; almost all realizations in my life have come when outside and quiet. Do not bring your iPhone. Do not bring a book. If it may end up in your hand directing your…
The Song That Changed A Season
My life has its own seasonality: harvests, barrenness, sprouts, and growth. This personal winter had been hard to shake. But decisively, a moment arrived, where I knew there was no need to keep the faucets dripping.
How I Survived 8 Years of Something I Didn’t Want
If you’ve made it this far with me, you’ve probably asked yourself, “How did he do this for so long?” To go to medical school, finish a residency, and become a psychiatrist, this guy must be crazy!
When It Finally Gets Better
Acceptance to medical school. I knew it then. Walking through the halls of medical school. I knew it then. Surfing the best waves on the West Coast. I knew it then.
Why I’m Quitting Medicine
I do not want to be a doctor. That feeling wouldn’t change—from medical school acceptance to board certification—and it required moving across the country, leaving my family, and becoming a psychiatrist, before I could act on it.
