My experience with burnout in medicine reflected a perfect storm (a lawsuit; a toddler at home with a second child on the way; a near-denial on a home loan; and working far more than I wanted due to two years of understaffing).
It led me to the path of financial literacy, which in turn set me up to become a do-it-yourself investor. This foundation (and the tailwinds of the past decade's bull market) set us on a path toward financial security.
The experience enabled a virtuous cycle of decoupling my retirement nest egg (as measured by net worth) from my clinical income, allowing me to cut back at work and in so doing rediscover an unexpected joy in practicing medicine.
Wresting back control over my time let me be more present for my wife and kids, deepen friendships, focus on fitness, and open me up to exploring new administrative roles that have let me use my brain in novel ways and restored my level of engagement in different facets of medicine.
As I've diversified my identity beyond medicine, I've found my overall "portfolio of happiness" is far less prone to volatility than it was when I felt more uni-dimensional.
I became so convinced that cutting back was a secret sauce to rediscovering joy in medicine that I created a series highlighting doctors from a variety of backgrounds of who have pursued this strategy for a multitude of reasons.
A conversation last night has helped me reconsider the need to diminish the role of medicine in one's life.
A study buddy from my med school days, the only other person in the world who remembers the same absurd mnemonics we once invented around midnight to prepare for the next morning's microbiology test, has led the sort of career that most med students dreamed of leading in their most idealistic moments.
She has built her life around the pursuit of her passion for medicine: prestigious scholarship recipient, MPH, stints at the CDC, political appointments in cities where she enacted public health victories that were hailed for placing citizen well-being above corporate interests. She's the real deal.
I surveyed the landscape of international public health and concluded the price of entry required too great a personal sacrifice, the role models were too flawed or dissimilar to my values, the rewards did not offset the personal costs. I fell goofy in love with someone who was similarly disillusioned and we abandoned our academic dreams.
My friend surveyed a similar landscape in her field of expertise and doubled down every step of the way. She sought positions under those administrations most supportive of fixing the world's problems, waiting out her time when she discovered certain positions that sounded enticing on paper turned out to suffer from bureaucratic sclerosis and micromanagement instead of facilitating real change.
To hear her speak of working to establish public health priorities with a team of brilliant and dedicated co-workers; serving a decisive political leadership supportive of her goals; and managing a budget that exceeds the GDP of many low-income nations!
It was wonderful to hear the enthusiasm in her voice. I could completely understand how she is intoxicated with an all-consuming life in medicine.
I still suspect that the majority of physicians do not experience comparable joy in medical careers that are often involuntarily all-consuming.
For most of us, lack of balance leads to falls, hip fractures, and intracranial hemorrhage.
But for a fortunate few, it can enable the career of their dreams.