‘Is there some secret you have learned that you wish you knew earlier?’
‘Medicine is a jealous lover…’
Working hard is a tradition in medicine. The braggadocio around hours of call without sleep, number of patients seen in the ER shift, numbers on the hospital service all speak volumes to the cult of work that is medicine. By the time you enter medical school, you are already indoctrinated into the cult. You worked hard in high school to get the right university. Worked hard in university to get into the right medical school. Worked hard in medical school to get the right residency. Worked hard in residency to land the perfect job. There is a theme…. Work.
It is no surprise that doctors struggle taking time off, taking a break. It is not something we do, we always work hard. There is an unspoken pressure to always be on, be right, to know, and that takes lots of work. It is an unclimbable mountain of ‘always’ but we try none-the-less.
I remember during school, I would be sitting at supper with my wife and mid-sentence would simply fall asleep. I could fall asleep sitting, sometimes even standing. I fell asleep at a stop light, sitting on my motorcycle, and fell over. This ongoing devotion to work was simply part of the deal in school, you know what I mean, look at how hard folks work even with the ‘duty hours’ in place. It followed me to Utah when I was in the clinic at Dugway. There was a time where I was the only doctor for the post for over 6 months, thought nothing of it, being on call every day, seeing patients every day, never leaving the post. It was life, it was medicine, it was expected.
In residency, I would moonlight on the side, working hard until I had a bleeding ulcer. Standing in front of the GI doc who had just scoped me, hearing him dress me down for working too hard, I remember thinking, ‘I am going to have to smarten up’. I did for a while, then transitioned out of residency into academics and once again found a way to work all the time. I worked in medicine, in academics, in research, with a side of farm chores just to make it interesting.
“No matter where you go, there you are”- Confucius
We moved to Prince Edward Island to ‘get away’, to try once again, to find a balance in life. In just a few short years I once again built a mighty empire of work. But this time something was different. Nancy asked me how long I was going to do the same thing and expect a different outcome. That was a most valuable conversation that shifted my point of view, it moved my attention from the outside world to the inside world. I began to look at how I spent my time, and what it cost me. A book that really changed my point of view was ‘Overwhelmed: Work, love, and Play When No One has the Time’ by Brigid Schulte. As crazy as it sounds, the exercise where I looked at how I was spending my 168 hours each week really rocked my world. I had been living my life as if I had all the time in the world available to me, and the realization that I only had 168 hours each week that stopped me dead in my tracks. Tracking how I spent my time, seeing medicine consume more of my time than everything else, was eye opening. I was shocked, although no one else was. Medicine is a jealous lover, always asking for more, until you have lost track of your real relationships, until they have come to see their second-class status in your life. In the moment when you see how you have cheated on your life with medicine, you come to understand what has been lost and gained, and in that moment that you begin to break up with medicine.
Breaking up with medicine can be hard, especially if the relationship has come to define who you are. It is a disruption of a long-term relationship, hard and fraught with anger and worry. It is a dark night when you see what has been done, freely, by your own actions, to those who love you most. But it is this dark night that brings about the clarity of morning light. It is the realization of what has been given that cannot be returned, what has been lost that is beyond retrieval, that burns through your heart in these moments. It is the burning away of the selfish pride. It is a fire we need to feel in order to clear away the dead wood in our life, allowing new growth to arise. For my part, I let it burn me good, burn until I felt like I had nothing left to toss into the flames, allowing myself to be melted and pliable so I could begin to reshape into something new, building on the scaffolding of these hard lessons learned. So I say, work hard, commit yourself fully to the cause that is medicine, allow it to wear you down until you burn in the fire, for when the ashes are cool, what rises will be far more beautiful than what was burned my friend, and I will be standing near that fire ready to greet you with a knowing look and a big hug.
This is a series of letters to a young doctor form so long ago, please follow along with me as we explore together this life in medicine and touch the history that has formed in the process. If any of resonates for you, and you happen to be curious, and wish to know more, do not hesitate to drop me a line. If you would like to know more about my work, or to work with me, feel free to contact me. I post regularly to Instagram (@gilgrimes), Twitter (gilgrimes) , Medium and Facebook (gilgrimes) about whatever arises. And if you would like to stay in touch sign up for my newsletter (probably once or twice a month at most).