Ordering Off The Menu

crispydoc Uncategorized 12 Comments

I Recently Overheard Someone At A Table Near Mine Order Something That Wasn't On The Menu

Docs who cut back demonstrate an aptitude for envisioning possibility where others cannot.

They sacrifice income to gain time to pursue balance.

They create and sustain unconventional arrangements with employers and colleagues, and find ways to package these arrangements fairly so all affected parties gain value through their participation.

I was thinking about this recently as I conducted an interview with Dr. ATC, who left a coveted academic position with an upward trajectory in favor of a community position that proved a far better fit with her goals for family life.

Dr. ATC remained the engaged, passionate learner, and simply channeled her powerful intellect into new areas that piqued her interest. She researched how to optimally provide her children an education that met their individual needs. This led her down the path to home schooling.

She eventually joined a cooperative where she and other parents rotate in the role of teacher for kids who are home schooled. Pursuing her interest led her to organize conferences on effective communication, mental health and individual learning strategies that grew out of her desire to understand home schooling.

This exemplifies what I'll call ordering off the menu.

Once you begin to choose your own career adventure, you feel a sense of infinite possibility that most of us feel only briefly when we transition from a lifetime spent on obtaining an education into a lifetime of productivity and work.

A lot of the slog of conventional living is feeling you've run out of options and painted yourself into a corner.

For those of us raising families in suburbia there's a sense that our destinies were stamped from industrial strength presses that churn out doctors to document charts to justify billing to generate salaries to pay down the mortgages on our little boxes (see video below). Our patients somehow evaporated from the equation.

How Do We Handle Information That Disrupts Our Notion Of Reality?

Another example: local friends with two elementary school aged kids sold their remodeled home, put their earthly possessions into storage, and bought the family tickets abroad for a year of travel around the world.

The community response followed the five stages of grieving outlined by Kubler-Ross.

  1. Denial: What they are doing sounds impossible. They'll never do that.
  2. Anger: They are going to screw up their kids and blow up their retirement!
  3. Bargaining: Could we do that?
  4. Depression: We're different, we could never do that.
  5. Acceptance: What they are doing sounds extraordinary.

It's weird to think that the response to seeing others undertake something as extraordinary as a dramatic reinvention or rejuvenation might be grief.

It takes a self-assured misfit to pursue priorities that conflict with conventional wisdom on career advancement.

Perhaps it makes more sense if we consider the grief to be for our own loss of potential, a forsaken sense of possibility.

Those who order off the menu understand that feeling stuck is a dreadful existence, but staying stuck is a choice.


Comments 12

  1. I like the ordering off the menu concept. Life is not some cookie cutter event or one size fits all.

    As physicians we do have a powerful negotiating chip which is our skills which are still in demand. This can be used to negotiate a situation where you design a life you want if so inclined rather than accepting the conventional work contract.

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  2. Great post. I agree that having the creativity and courage to break the mould and be driven by your priorities rather than “the script” makes for a more fulfilling career and life. It is a hallmark of leadership.

    So, it doesn’t surprise me that many of the docs who do this are also clinical or academic leaders. Many stay in those roles in a traditional sense (which is great – we need them). What may differentiate those who move in a different direction is a broader view of the world. Off the menu. That could be within medicine (for example developing new programmes or solutions to challenges), at home, or in the community. I have seen a number of people do this first hand. Your description of the grieving process really does describe the reaction accurately. The cases where I have seen the strongest reactions have also been the ones where later there was the more than just acceptance, but admiration.
    -LD

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  3. Oh wow. I can totally relate to the five stages! That’s how people reacted to us when we told them we were moving to Medellín for the summer! We finally stopped telling people because it was becoming emotionally draining to “fight” with them during their initial stages of grief. Yes-order something else-it makes life interesting.

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  4. I first began ordering off the menu when I designed my own major in the engineering department at Stanford… this only led to skipping lectures the first two years of med school so I could study at the beach. Fourth year I took my final two electives abroad in London and Paris. I can relate to this topic!

    Unconventional. Yep, that’s me.

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