your mileage may vary

First year. It started out as a joke. “I left my career for this?!”

Med school and I were still on our honeymoon. There was a lot to study, but I remembered enough from my prerequisite science courses and I learned enough physiology on the job that it was bearable. There was still free time, time to volunteer, time to hang out with friends and family. It was almost like being in college again.

Second year. The fire hose of knowledge that one is expected to handle was wide open. The stack of pancakes that is daily studying grew high enough to rival the tallest buildings. People were unhappy with the recent changes to the curriculum. Negativity was everywhere. The stress of studying for our first board exam was wearing everyone down. I was worn out. “I left my career for this?!”

It wasn’t that I loathed my job or that I wasn’t good at it. I was good at it. My manager’s manager told me up front, in an effort to get me to stay, that there would be an irreplaceable void in the team when I left. But the truth is that it took me a long time to get to that point, to develop competence and credibility.

And here I was starting all over again.

It was easy back then to rationalize it. There was only me. I didn’t have a wife, children, anyone, who would be impacted by my decision to start all over again, to trade in a good-paying job with good benefits so that I could accrue an amount of debt equivalent to a decent home in a reasonably affordable mid-sized metropolitan area, to trade in my nights and weekends of freedom for nights and weekends of working and studying until my eyes bled, to trade in a life (albeit somewhat temporarily), all because of the notion that I could accomplish more doing something different. Hell, I was still in my twenties. Things looked different on that side. There was still a lot of time. Lots of time to do everything I want to accomplish. Be a doctor. Get married. Have kids. Buy a house. The usual.

I turned 30 and then a few months later left my career as an engineer behind.

Third year. Over halfway through it. Days spent essentially working at a job. Nights spent studying. Learning, learning, learning. Getting the tiniest bit competent. Once that happened, it was time to move on to a new rotation. Like clockwork. Time to start all over again. And so that feeling of “hey, I think I might know what I’m doing” has been nothing but fleeting. It has been a losing battle to not let the anxiety and worry over looking like an idiot in front of the people who write my evaluations render me insensitive to those meaningful moments when I might actually contribute something positive to someone’s care, to the point where “burned out” feels like an understatement. And now that I’m approaching the phase where I need to start thinking about what I want to specialize in and applying for a residency and all of the advice people give you basically distills down to “be better than everyone else” and I’m earning passing grades in my rotations but is that really enough because my board scores weren’t stellar and I swear everyone’s better and smarter than me and residencies are getting more and more competitive will I really succeed?

…I left my career for this?

oh hell I’m going to be turning 33 soon and why do things look so differently than they did four years ago and dear god what the hell have I been doing with my life when will I ever have time to do everything else I want to accomplish*

I’m not going to quit, but maybe this is as low a point as I’ll ever reach.

* * *

Lately, though, maybe the universe has been dropping me messages to suggest that I might be doing all right:

Night float week on pediatrics. Last day. I have a new-to-me intern. We get to talking. Turns out she also majored in engineering, still has the engineer’s mindset, had the studying mindset of an engineering major: problem sets. Lots of them. Full of math. Lovely math. Calculus and linear algebra and all the wonderful things. Logical and algorithmic.

She related to me her own experience in med school, the paradigm shift involved in studying through reading and memorizing. It was like she was recounting my own story. We talked about ways the engineer can find a niche in medicine. She described an attending she once had who was a former engineer and how he would articulate his thought processes on rounds and no one else seemed to grasp it but she did because she had the same mindset. It was reassuring.

Thanksgiving dinner. Curious to see how much of my aunt’s piano lessons still stuck, I sat down in front of my brother’s keyboard, confronted with “Jingle Bell Rock.” Slowly, tentatively, I sounded out the notes and chords in front of me. My fingers weren’t used to playing more than one note at a time, and they clumsily moved about from key to key in a way that reminded me of painfully awkward grade school dances.

My brother came into the room. “Do you want to borrow my keyboard?” I shrugged.

“You should.” He paused. “You have an artist’s heart. I can see it in your photography. And I can hear the joy in your voice when you sing. … You’re going to be entrusted with people’s lives. It’s going to be stressful. You need this.”

Pediatrics intensive care unit week. Last day. In the middle of morning rounds, we hear, rather loudly: “CAN I GET SOME HELP HERE?!” We start to hurry in that direction. The attending asks which patient it is. On hearing the name, she runs quickly ahead of us. It was a patient of hers that she’s taken care of for his entire life, a baby who’s only ever known the hospital.

I had been running towards the call for help for a couple of seconds before remembering the right people to help were on their way. I found a spot where I’d be out of the way but where I could still observe and provide manual labor if an extra pair of hands was needed.

In those minutes the team worked together to give a critically ill child every chance at living.

I left my career for this.


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