I was in junior high school the first time I accepted a friend's invitation to join him in the Pacific Ocean. He'd been surfing since grade school, and agreed to lend me a spare bodyboard for our afternoon at the beach.
After his mom dropped us off, he wrapped a towel around his waist and shimmied into a full length wetsuit while I soaked up the awkwardness of wearing only the off-brand swimsuit I'd owned for years. It was autumn, and as we paddled out into the lineup I experienced immediate shrinkage. This post, dear reader, will spare you discussion of that type of shrinkage. Instead, I want to talk telomere shrinkage.
For the non-medical reader, telomeres are a biological equivalent of the tape at the end of your shoelace that keeps the entwined threads from unraveling. Telomeres serve that function for the DNA in your cells, shortening slightly each time a cell replicates. Once telomeres shorten to a terminal length, cells either enter a state of senescence (they no longer replicate) or apoptosis (they self-destruct). It's no surprise to learn that shortened telomere length has been associated with various age-related illnesses.
A recent article in the New York Times highlighted a study of medical trainees in which DNA obtained from saliva was sampled at the start and end of their first year of residency to determine how telomere shortening compared to the population as a whole.
Brace yourself: first year residents had telomeres that shortened at six times the rate of the population as a whole. Worse yet, those who worked over 75 hours a week (and you know who you are) had telomeres that shortened at thirty times the rate of the population as a whole.
The question becomes a matter of what one considers a favorable exchange rate. When I was medical student, a classmate submitted local legislation proposed a cap to the number of hours residents could work in San Francisco. Counterintuitively, what was hailed by the local lay press as a long overdue public safety measure was protested by the residents most likely to be affected.
Shorten my weeks and lengthen my years of training?! a different classmate aspiring to surgery complained to me, incredulous that his desired intensity of training would be regulated by anyone outside of his field. (I just googled him - he's become an academic surgeon.)
I could understand where his frustration was coming from - he'd put in the required hours, and now someone threatened to move the carrot that much further beyond his reach. He was willing to work fewer years, more intensely. Really, what's a little telomere shrinkage among friends if it gets them to the attending stage of medicine that much quicker?
This is a potentially dangerous calculus, and (not unlike debt numbness with student loans) it can be a terrible idea to let someone make decisions now that they pay for longer and later in life. It's a form of market timing - you are assuming the exchange rate you can get now (time for money, time for health) is the best deal you'll have available going forward.
Often time the sacrifice you made while young (What's a little less health? What's a little more debt?) is valued in a profoundly different manner when you reach later life (What I wouldn't give to have a little more time in the form of better health or less debt and less of a need to work!).
It reminds me of how friends in college formerly described their decision to smoke. They assumed they would live a perfectly healthy life and then die suddenly in their sleep at 80 instead of 85 for having smoked. No one envisioned a decade or more of being tethered to an oxygen canister, limited by shortness of breath with minimal exertion, unable to dance at a grandchild's wedding from COPD.
From a financial independence perspective, it has different implications. I met with a friend a decade younger than I am for coffee last week, and we talked about his current shift tolerance. He felt comfortable pulling off 14-15 shifts a month, and had built a beautiful spreadsheet that extrapolated out this workload going forward for the coming decade in planning out his financial situation. I give him credit for taking the initiative to put together a spreadsheet and map out debt repayment and other financial milestones.
He's young and hungry, and I clearly remember the feeling of invincibility that comes with that stage. Still, we discussed how it can be hard to anticipate the pulls you'll feel and the person you'll be a decade in the future. Instead of making workhorse assumptions, better to plan for a lower clinical burden (with commensurate reduced income) in the last 3-4 years of the decade, and if he's able to remain at 14-15 shifts a month, let it be a pleasant financial surprise.
My burnout was not a predictable milestone and there was no anticipating the impact it was going to have on my financial trajectory. My course corrections won't lengthen my already shortened telomeres, but with more years behind me than ahead of me, I have a vested interest in reducing my rate of shrinkage as drastically as I am able.