I was one lucky son of a gun: 22 years old, graduating college, accepted to medical school. I had an airline ticket (thank you, generous aunt and uncle), a Eurorail pass (thank you, savings from college gig as a Sunday school teacher), and a ginormous new Eagle Creek backpack bought on sale (if only I’d known to travel carry-on, or that used is the new black).
The catch: I’d never traveled solo before. I recruited a close friend to accompany me, only to have him cancel a couple of months beforehand. I was excited, intimidated, and clueless.
The key to living well is living not just within, but comfortably beneath your means. This means cultivating habits that will reward you in the future. One key habit is to adopt a perspective that allows you to appreciate how good your life is right now. While it has always been fashionable (if tiring) to whine about low resident compensation, such complaining is often based on incomplete information and a lack of perspective. When a hippo compares itself only to elephants, it can start to believe it is small.
In medical school we studied necrotizing fasciitis, colloquially dubbed "flesh-eating bacteria" in the lay press. One of the hallmarks in distinguishing this disease from less aggressive soft tissue infections is pain out of proportion to physical exam findings.
I'd come to remember this concept decades later, as I began to develop a reciprocal theory: pleasure out of proportion. (Decontextualized, this might sound like a hedonist’s call for more hookers and blow - not my intention.) In my mind, pleasure out of proportion referred to those pursuits that made me deliriously happier than could be rationally explained.
Freshman year at Stanford had been a humbling experience. Everyone around me, it seemed, was smarter, more experienced, more accomplished than I was. Shawn Green was a personable guy in my dorm - and the only frosh I knew getting a $725,000 signing bonus as a first-round draft pick for the Toronto Blue Jays. Our dorm also claimed the new quarterback, a handful of All-American Water Polo players and a Junior Olympic sailor (not counting the acquaintances from nearby dorms that went on to win gold in the following year’s Olympics or sweep several consecutive NCAA volleyball championships). I use the athletes because they quickly illustrate the level of excellence surrounding me; the academic and intellectual playing field was just as crowded with talent.
I had just turned 40, and was leading a busy life that might resonate with your own: a full-time job in community practice, marriage and fatherhood. Since I didn't want to take time away from my wife or kids, self-replenishing (i.e., pleasure out of proportion) pursuits suffered. A writing group I'd started in internship began to founder because the handful of friends I'd recruited succumbed to competing time commitments. The day hikes and bird watching treks that had provided essential solitude were cut. Kid #2 arrived and suddenly date night disappeared. Even the sanctuary of the bathroom was violated. My son developed the habit of assembling a puzzle on the tile floor during my wife's morning shower, while my daughter planted herself firmly in the doorway after breakfast during what became our daily "potty talk."
You’re a busy person, you want only the essentials: what can you do today (as a med student or resident) to make your life better tomorrow? Following is a basic tool kit with immediately actionable items, to be elaborated in later posts.
Last night, in a mood of playful optimism, I asked my wife what she thought the next decade might bring our way. She remained elusive, and qualified her non-answer with her own version of of the spit-over-your-shoulder superstitions that my grandmother (who believed in witches) might have engaged in when I was a child.
I tried to explore the source of her unease, and realized that when she thinks of the future, it’s a source of great anxiety.
Part 3 of 3: Breaking Up With My Financial Advisor
Ignorance Becomes Unaffordable
Fast forward a decade. After my physician group institutes some changes that significantly improve our collective lifestyles, my work-life balance is restored and I am reading voraciously once again. In February 2016, an article in The New Yorker profiles Mr. Money Mustache. He and his wife, both software engineers, spent 10 years working intensely and saved 70% of their annual income to invest it. They achieved financial independence at age 30, just before having a kid. Financial independence is defined as having sufficient assets so that the investment income generated covers your annual expenses. Put another way, you have accumulated sufficient Free-You money so you never have take a job solely because you need the cash.
Part 2 of 3: The World's Most Expensive Bottle Opener
Getting a Financial Advisor
In 2005, I finished a two year fellowship in Boston; fell goofy in love with another physician; renounced the academic trajectory I’d been on; relocated with my girlfriend to a beach town in southern California; and accepted a job at a well-regarded community hospital. I had 80k in tax-sheltered accounts despite zero financial literacy. Thanks to a combination of parental influence, dumb luck and constitution, I’d developed the habits of a saver.
Part 1 of 3: A Fool And His Money Are Soon Parted*
Financial ignorance makes no distinctions. Perhaps you were raised by doting, professional parents in a luxury home with a generous parental allowance that shielded you from ever having to think about money. Or conversely, like Jeremy at Go Curry Cracker, your single parent household was in sink or swim mode financially and your community role models ranged from spendthrifts to subsistence earners living on minimum wage. Either upbringing can render you totally unprepared to manage your finances on reaching adulthood.
Financial Literacy for The Newly Minted Physician