The easiest decision

graduation

Mom and me at medical school graduation in 2002

Almost four years ago now, I retired from medicine at age 37.  It feels like I should be saying this in front of a group to whom I’ve pledged anonymity.  “Hi, my name is Angie.  I’m a recovering physician.”

I’ve already told this story countless times to people whose responses range from confusion to concern, pity to envy.  I contemplated whether a public admission is even necessary, or is it simply more self-satisfying hubris?  The other day a friend sent me an essay written by a woman who had retired from medicine at 37.  I haven’t been able to read it–I think it’s something about wanting to get my own story out there before I become an accidental copycat.  So here goes!

The facts of the case are as follows:  I went to medical school straight out of college, where I met my future husband.  We then moved to Arizona where I completed a residency in pediatrics and practiced at a clinic for two years before we returned back to Wisconsin.  Then I joined the faculty at the Medical College of Wisconsin and practiced as a pediatric hospitalist, taking care of kids ill enough to require hospitalization.  I flatter myself that I was pretty good at the job, and I especially enjoyed the teaching duties that came along with it.  I was doing well and had garnered some awards and leadership positions during my six years there. During this time we had two children, and we managed to hobble together a two-physician life with the help of nannies and family and luck.  I grew increasingly disenchanted with my work, and I assigned most of that feeling to the world of academics.  So I left and joined a local general pediatric clinic–the BEST clinic imaginable in all honesty.  Wonderful coworkers and patients, just really everything.  And I remained gnawingly unhappy.   And I retired.

I realize how lucky I was to have been able to indulge in contemplating my dissatisfied feelings, let alone acting on them.  Were I not married to someone bringing home a nice salary on his own, there’s no way I could have retired.  I would have been trapped by my student loans, which we only just recently paid off.  I totally get that I was lucky to even be able to see leaving medicine completely as a viable option.  But as soon as it reached that level of viability, my decision was simply.  It was getting to the point of not worrying about who I’d disappoint / what others would think / loss of identity that was the hard part.  After that, the decision was easy and the path forward clear.   And I have a lovely spouse who greeted my decision with “you only live once” and has never once made me feel guilty about it.

Since quitting medicine, every few months I’m contacted by a colleague from a past stage of my career.  They are generally going through some turmoil surrounding their medical life, and they want to talk it through.  I think they want my practical opinion and advice.  But I think that I also serve as a living worst case scenario–I quit the thing entirely and emerged intact.  It’s like they are wanting to touch the nail holes to confirm that I am, in fact, still alive;  wanting to prove to themselves that life after admitting disillusion with medicine is possible.  Awhile back yet another female medical colleague contacted me to hash through her moderate dissatisfaction with her medical career.  I had NO IDEA that was the purpose of our lunch date;  I didn’t see it coming from her.  Usually the calls I field are from women my age (for interestingly, all of the advice-seekers have been women).  However, this colleague is probably about 10 years my senior and childless.  Two of the most common denominators of the typical conversation were absent, and she is REALLY REALLY good.  I didn’t see it coming–either her malaise or need for my perspective.  Even the most stalwart have these moments, I’ve learned.  Medicine does that to a person. If she found use in my thoughts, then they are worth publishing.

Before I launch into my lessons, let me reiterate that the field of medicine remains a noble profession that is truly rewarding for many, my husband included.  His role as a physician is vital to his sense of self, as it is for so many of the best.  I simply wasn’t cut from that same cloth.  Further, I do not mean to discourage ANYONE who is truly called to that life and profession–for medicine is both.  I mean, instead, to allow space for anyone needing it to contemplate some of these Big Questions.

Here’s my thoughts about the process of entering medicine in general, at least in the U.S. system:

  1. Once a person has matriculated in medical school, there’s no looking back.  The competition to get in is so fierce, the classes are so rigorous, the peers so singularly focused.  There is no time–either literally or metaphorically–for a medical student to pause and query:  “is this path I’m on leading to a life that I really want?”  Which is too bad because…
  2. The degree of debt that most students take on to complete their medical training necessitates that they practice medicine for at least 20 years.  The repayment schedule is such that a move into a similarly-well paying entry-level position in another field is virtually impossible.
  3. Most 22-year-olds have no idea what they really want in 15 years, the time when the reality of life as a physician (following the years of schooling and residency) truly sets in.  It is challenging to try and introduce the topic of work life balance and delayed child bearing to this age group, especially when they are immersed in the culture of #1.

Here’s my lessons about myself in particular, with thanks to a particularly skilled therapist:

  1. I went to medical school because I was very good at school and had little confidence in anything else about myself.  Believe it or not, I fell rather thoughtlessly into the decision.
  2. I ignored many warning signs of my poor fit and developed unhealthy coping mechanisms to deal with them.  However…..
  3. I met my most important people through these life decisions and, therefore, wouldn’t change them for anything.
  4. Medicine is an especially difficult profession to emotionally manage if you are a people-pleaser by nature.  And paradoxically we pleasers make especially good providers.

If people are at all interested, I plan to break down in an occasionally amusing fashion some of those numbered items above.  It’s hard to admit things like this, but at least now I can go read that essay my friend shared with a clear conscience!

14 thoughts on “The easiest decision

  1. Jan Quinlan says:

    This is wonderful, Angie. Intelligent thoughtful and an insight into the medical profession that I haven’t heard before. It rings so true. Thanks for sharing it.

    Like

  2. Nikki says:

    Thanks Angie—loved this. The complexity of these decisions can sometimes be so tangled that I admire your clarity. Feel my virtual hug? Miss you!

    Like

  3. Bill Madden says:

    Angie, you speak truth, your truth but a truth that would speak to many. My standard career advice ( and words that I have tried to follow myself) is to do whatever you are doing until it is no longer fun. When the fun is gone, do something else. In my career I did everything from intensive care to international health. I taught, did administration and much more. Why did I continue evolving in what I was doing?, Because after a while what I was doing was no longer “fun”. I was fortunate that for many years I was able to find a new path within medicine that satisfied me, challenged me, at least for awhile. But the day finally came when that was no longer true. So, I quit medicine, just like you did. It took me a few more years than you, but the reason was fundamentally the same. I wanted time with my family.

    So, well done, both in your decision and in your writing.

    Like

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