Cutting Back

crispydoc Uncategorized 4 Comments

Once upon a time, a strapping young buck dove into the field of Emergency Medicine with ne’er a thought of night shift fatigue.  He loved his work, headed into each shift bright-eyed and bushy-tailed and relished the butterflies in his stomach that multiplied commensurate with the number of ambulance rigs in the emergency lot.  He loved the social justice aspect of caring for the patient without caring if they were insured.  He loved sewing lacs on alcoholics who shared their life stories (and occasionally their gastric contents) as if he were their personal bartender.  He even tried to learn something new about the delusional homeless patient who visited the department almost daily in the belief that the air in the ED was somehow salubrious (it was mostly noxious).  He felt lucky – someone paid him to do this!

He was young and single, an unattached helium balloon floating freely and energetically through life.  Sure, our hero might sleep poorly (or not at all) the next day as he recovered poorly (or not at all) in time to see friends.  He’d head back to work smiling, as his patients told him he looked too young to be a doctor.  He’d get enough sleep when he was dead.Fast forward to 15 years after his last days of residency.  There are crow’s feet at the borders of his eyes, and a generous interpretation might suggest they come from years spent grinning in Caifornia sunshine (partially true).  His wife, herself an emergency physician who cut out nights a decade ago, misses him on the weekends, when time alone with the children is most exhausting and when missing social engagements with friends sting more than they used to.  She knew his job would involve opportunity costs, but she resents them more than before.

The kids, once small dependent peach-fuzzed blobs that made poop, are now real people with opinions, needs, and too much homework.  They are capable of hiking and bodyboarding, of beating him at chess and drawing freehand portraits better than he ever could, of frying an egg and cleaning the dishes.  And their ages hover delicately in a rapidly-shrinking window period where they’ve decided they like him, and want nothing more than to spend time with him.  I believe it was Al Franken who said, “Kids don’t want quality time; they want quantity time.”

He still derives meaning (and pleasure) from the work.  But as peers are diagnosed with cancer and parents age, he grasps more than ever that time is precious.  This is more than a platitude: he wants to allot his remaining time on the planet to explore other versions of himself, versions that may not be compatible with his current physician’s schedule.  Perhaps those alternate versions will include a writer, or a teacher, or an advocate through a non-profit. Perhaps a naturalist, a do-it-yourselfer, a craftsman or artist or athlete.  Perhaps a counselor to youth in crisis.  Perhaps becoming a physician champion for a different medical model of care. Perhaps travel more slowly with family, under fewer restrictions.

This is not a secretary, sportscar and toupee type of yearning.  It’s a desire to be present for the people he cares about without distraction. A desire to eat more healthfully and dedicate more time to fitness so that the body he inhabits might last a bit longer. A time to appreciate that he married a woman out of his league. A time to test his brain and try his limits in new and different ways.  A time to avail himself of this window with his children.

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In a couple of months, I’m cutting back on shifts to a half-time work load, to make my actual career more closely resemble my ideal career. I’m excited about the possibilities this opens up, the sense of promise that accompanies this new crossroads, the chance to reduce the depletion that accompanies work. There’s also a tremendous satisfaction in once again taking hold of the reins of my life direction.  

For a long time I accepted unsustainable obligations because work stress seemed like an ordinary and unavoidable part of living.  I’m hoping reducing my shift load will put me in the extraordinary position of spending my time in accordance with my values.

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