I'm starting a series on Docs Who Cut Back, and I'd love to share your story if you have the time and inclination.
The therapeutic window of a drug tends to describe the range of doses in which it has the desired clinical effect. Too little and you lose the benefit you sought. Too much and you might die.
Medicine as a career has a narrow therapeutic window.
Too many shifts in the ED and I become unhappy, numb, a stranger to my kids, a burden to my wife. I grow apathetic as my life grows pathetic. This is not my beautiful house. This is not my beautiful wife.
The brilliant graphic artist and blogger-philosopher-king Waitbutwhy created a poignant and deeply affecting post entitled Your Life In Weeks that provides graphic summaries of a our time on this planet in viscerally intuitive terms. It makes you realize that All This eventually ends, so if you are unhappy with your All This, you'd best change it up as soon as possible.
There are different ways to implement change. Some people adopt radical reinvention: sell the house, sell the car, move to another state and start over. I decided incrementally changing my institutions from within to enable the career I wanted was going to be the best option for my situation.
It took a few years, but I changed it up. The color that had ebbed from my days slowly returned. A weird thing happened - as I cut back, my career in medicine moved from the toxic range back into the therapeutic window.
I genuinely like what I do now, largely because I do less of it more humanely.
I have the time to stay fit(ish), work on art projects or shoot baskets with my kids, and enjoy lunch at home with my wife most days of the week. The Venn diagrams of my actual life and my ideal life share significant overlap.
I'd like to think I'm not alone.
After years of careful looking, I can confirm the existence of a subset of misfits and non-conformists in medicine who have always been there, under the radar, practicing a sustainable brand of work-life balance.
If you are such a physician, and you cut back your clinical commitments as part of effecting this type of change, please reach out to me via the comments below or at crispydocblog (at) gmail (dot) com.