The second letter of the title above is deliberately capitalized to emphasize FI - as in Financial Independence. Since reducing my shift load, I was able to increase my participation not only in non-medical pursuits (pleasure out of proportion activities), but also in medical roles that are interesting (if unremunerative) to me. I got hooked on bioethics during a course as a high school junior at a UCSB summer program. Undergraduate seminars with a thoughtful mentor, Dr. Bill Hurlbut, made abstract medical scenarios seem real and meaningful. A deeply spiritual medical school mentor, Dr. Steve McPhee, taught me how end-of-life care intersected with my interest in medical ethics. Yet it was not until this past year, with the kids both in school and my shift load reduced, that I was found time to commit to serve on our hospital’s Bioethics Committee. The experience has rekindled a long dormant passion.
I’ve been able to arrange family meetings, help explain a patient’s condition in lay terms, and allow those with strained or otherwise difficult relationships with the patient in question to unburden themselves. I am able to bring great credibility to the discussion of code status and what occurs during CPR; in our hospital, emergency physicians respond to all in-house codes. In one case, a devoted daughter was able to explain the family landscape to me in advance so that I could help certain relatives move beyond personal guilt to respect a dying patient’s wishes. It’s some of the most meaningful and interesting work I’ve done in medicine in a long time, and I don’t get paid for it.
Interestingly, my passion has not gone unnoticed. A veteran nurse administrator who serves with me on the Bioethics Committee invited me to join a smaller subcommittee that reviews weekly data on prolonged hospital stays and determines which cases might warrant a Bioethics consult. While I don’t know where this new role might lead, it’s fascinating to have a seat at the table with someone in the “C suite,” even if it’s unpaid.
Reducing my workload has allowed me to re-engage with medicine and put me in a position where I help patients and their families acknowledge their fears, articulate their values, and define what death with dignity might look like if interventions fail.
I see the start of a virtuous cycle where the less I work because I have to, the more I work because I want to, and the more meaningful that chosen work becomes.
What would you do with a lighter workload?