A good friend of mine is trying to decide a career path, and having grown up in a very different culture, has choices and restrictions very different from what mine were.  Nevertheless, without asking in advance, admittedly a bit rude, I offered some thoughts, my own story, hoping perhaps it might help.

I wasn’t happy in medicine.  Neurology would have been a great specialty for me fifty years prior—even 20 years—before imaging tests allowed most physicians to diagnose many conditions that hitherto had been the province of neurologists.  I was left with the complaints of headache, spine pain, limb pain, and dizziness, 45% of my new patients (I counted), where imaging tests were normal and my training to deal with these conditions practically non-existent.

Night call was dreadful.  I didn’t sleep well, even on quiet nights.  I hated weekends, especially when my partners decided (with my dissent being the only one) one person be on call the entire weekend.  I was the only one in my group who took off the following Monday afternoon, not the whole day, because it took me all morning to get everything cleaned up from the weekend. I was on call 582 nights during my time with the group, and I then wondered what was the toll was on me from lack of sleep—how many errors I made, how many times I was unnecessarily nasty, cruel, or mean.

I knew I had to do something different, so I decided to take a 6 month leave of absence, 6 months of retirement at age 43 to work as a volunteer for the Superior National Forest, being a wilderness ranger in the Boundary Waters Canoe Area Wilderness,** a million acres of lakes, rivers, and forest—no roads, no cabins, no powerboats.

That time was perhaps the most content I ever have been in my life.  I was in the woods 100 days that summer.  I learned the Boundary Waters like my neighborhood, traveling hundreds of miles through 300 different lakes.  I was strong and soloed 15 times, single carrying (canoe and pack) a mile without stopping.  I traveled 6 days solo without seeing another person.  Didn’t mind that, either.

But winter comes to the North Country and I had to return to my practice, never having had the epiphany one night by a campfire, when I would suddenly realize what I was going to do with my life.  That is what I thought would happen.  It didn’t.  Back in practice, I was calmer but I still was dissatisfied with my life.  Then, quite by chance, the medical director of the hospital resigned for another position out of state and I decided to apply for the job. I wasn’t sure how it was going to work, only that it was more to my liking than what I was doing.

I liked the job, learning a great deal about medical management.  I never would have dreamt during my training I would become an administrator.  Nor would I have predicted that hearing Brent James from Intermountain speak on medical quality would be life altering, and that I would not only take his 4 month long course in Salt Lake City, but I would ultimately leave medicine in all forms to pursue a Master’s in Statistics.  No, I never foresaw this.

Nor would I have guessed how I would have failed at being a medical statistician.  I had closed a door, one that paid well and gave me power and influence, but it locked behind me.  I couldn’t go back.  Instead of a bright world in front of me, it was as if I were in a hallway, with a lot of doors, all of them closed.  Only one was unlocked, and I entered a room, the door’s not locking behind me.

This imaginary room was like a classroom, as if I were back in school, doing two things I liked and was good at—teaching and math—and another that I liked but wasn’t good at—writing.  Somehow, I cobbled together a new life of writing about patient safety and medical errors for magazines, became a columnist for the medical society and Physician Executive magazine, and continued writing a weekly astronomy column for the newspaper as well.

Quite by chance, which became three words that would define my life, while looking through a drawer one day, I found “The List,” things I wanted to do in my life, ignored for two decades.  I started to dream, then I started to act.  I began in 2004 with seeing the Sandhill Crane migration, and then began the following year to see the national parks, beginning late 2005 with Guadalupe Mountains and Carlsbad Caverns.  It was as if I had opened an imaginary door and gone literally and figuratively outdoors, without the door’s locking behind me.  I had written down “See Alaska’s Arrigetch Peaks,” and I did in 2007.  That led to five more Alaska backpack trips to the Brooks Range.  I had learned that writing a column was like my life—I didn’t force things to happen, I recognized opportunities and tried to act upon them appropriately.

In 2010, cold weather in Nebraska and a delay in the arrival of the cranes led to my returning in late March, which was life changing, for instead of being at Rowe Sanctuary before the public arrived, I became a guide to the viewing blinds, going again this April for my seventh consecutive year. That July, I planned to see the total eclipse in Patagonia, but the flight-seeing plane we had booked to fly over the almost certain cloudy country was cancelled, meaning our chances of clear skies in the austral winter were about 5 per cent. I nearly missed making the plane to Buenos Aires, which I wouldn’t have minded missing, but found myself 2 days later in Patagonia under thick clouds the day prior to the eclipse.  Yet the next day, in a clear sky, I and a large tour of mostly Germans saw the most striking of the 15 total solar eclipses I have been fortunate enough to see.  The friendliness of the Germans I met led me to try to learn their language.  I won’t ever finish the job, although I watch far more German than American shows on TV.  There was no way I could have foreseen either of those two events that year.  Quite by chance.

When we moved to Oregon, I knew that I would do something and was perhaps wise enough to know that I would do things that I could not possibly foresee, and other things would not work out as planned.  Leading hikes, tutoring math at the community college, and running planetarium shows could not have been predicted by me, but I do them.  Two weeks ago, I went snowshoeing for the first time in my life. (Salt Creek Falls, Oregon; February, 2016).

What I told my friend was not to force any decision about school.  Think about what you like, I wrote, and keep your eyes and ears open for opportunities.  Take some risks.  You might end up in a brand new world, or you might end up in a hallway with a lot of closed doors.  Try them all.  I bet at least one will be unlocked.

Quite by chance.

At right, trip leader to Black Crater, Oregon, 2015.

**”The examiner re-examines” and “Burnout or rejuvenation?” were my words, except for the title, that Steve Nash, former Executive Director of the Pima County Medical Society and now of the Tucson Medical Osteopathic Foundation.  I deeply appreciate his taking my words and adding his style to the medical society publication Sombrero.



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