It has only been a mere thirty-one days since the post announcing the cataclysmic shift in my aspirations, yet my time in medical school feels far in the distant past. I suppose I can owe it to the stark contrast between my lifestyle then and my now stagnant circumstances, but regaining my free time also puts into perspective just how much time one is given to either use or squander.
Recently, I was forced to flip from one of these extremes to the other; all of a sudden, I have a lot of free time to sort out my thoughts and consider my options moving forward. At the same time, I was enormously grateful to receive an outpouring of support from my friends, family, and frequent readers to guide me during this ordeal so I felt it prudent to further expand upon the thoughts going through my head and how things are looking one month later. As one can probably imagine, there is a lot going through my mind right now, so I would like to organize them into categories:
– The Past
I do not like dwelling on the past– neither for fixating on bad experiences, nor for reveling in the good ones. One who focuses on his misfortunes tends to fall into a void of self-pity. At the same time, one who becomes the person always reminding friends about the exploits they shared years ago soon loses track of time and is unknowingly left behind while others move on. The water of time flows ever onward; the one who chooses to fight its passing will only lose more of what he was trying so desperately to protect in the first place.
Despite such a regard however, I take issue with people who completely ignore the past and live with a blind “no regrets” mentality. I believe it responsible to identify some regrets– while I do not consider it mandatory (or even advisable) to brood over them, I feel that they bring with them valuable lessons for the future. As such, I fully recognize and advocate reaching into the past to help make new decisions, especially where mistakes may be repeated otherwise. This is where I am at right now. Despite 4+ years of smooth sailing, I had to abandon ship; I need to ensure that such an event does not repeat itself by planning very carefully as I rebuild.
In order to do that, I have to retrace my steps… and certain steps are a little bit painful to look back upon. Rather– I feel that “painful” is too strong a word; the actual emotion is a combination of glumness, wistfulness, and perplexity. I sift through my memories to figure out whether I took a wrong turn somewhere or whether I ignored a warning sign of some sort. I reflect upon the reasons why I chose to embark on the path of health care and why I stopped considering my pursuit of becoming a physician worth trudging through. If I am to commit myself to a fresh new undertaking, I want to be able to do it fully.
For brief moments, I recall what an adventure it was to fly across the country for my interviews– a brief escape from college into a world of hotels, airports, and rental cars. I remember how confident and secure I felt as I taught my physics students and used my authority as president to transform my pre-medical organization into a wondrous stage show of comedy mixed with pedagogy. I reflect on my decision to skip my graduation ceremony in favor of celebrating my White Coat Ceremony with my family… and how happy I was to finally walk the stage.
… and for reasons I cannot explain, my thoughts continually come back to the song I heard over and over again during my trip to the Magic Kingdom at Walt Disney World the summer before medical school: “Any Dream is Possible”
– The Now
It is a somewhat odd notion– the thought that one’s dream may no longer be possible. The sentiment has a nuance of finality, similar to having a kidney removed; a part of you is gone. But as I stated in my last post, there were options if I really wanted to take them. While the paths still open to me would take a lot of time and money, I could have still become a doctor if I really wanted to. Instead, I decided that the title of “doctor” was not worth sacrificing other things I valued, such as living life without a mountain of stress for a decade. I gave my “dream” up willingly– does that mean it was never my dream to begin with?
…That is the conclusion I have tentatively settled on. I may have regarded my goal to become a doctor as my dream before, but I feel that it was an illusion obscured by tunnel vision traveling the linear pre-medical path I set foot on years ago in undergrad. No, I do not believe my dream was ever as simple as a title to place next to my name; I have always hoped to get something more meaningful out of life. As I have always relayed to my friends, I value the journey– the adventure. While I cannot fly through star systems or laze along the waterside of Al De Baran in real life, I can strive to lead a fulfilling life both where I can enjoy my career and have the time/finances to pursue my own personal aspirations. If one is able to be content both in helping others and helping raise an animated little microcosm at home, what more can one ask of life? The difficult part of course, is improving one’s quality of life to that level.
Right now however, despite my renewed faith in the achievability of my dream, my life is at a standstill. No longer am I enrolled in any form of academic program and, due to the timing of things, I am currently unemployed on account of most positions being filled for the season. With practically nothing to occupy my time anymore, I am essentially suffering from whiplash after going from a life with no free time, to one where it is seemingly unlimited. As I now sit in my apartment living as I did during the summer vacations in high school, currently living only off the charity of my ever supportive and loving parents, I feel profoundly out of touch with the “real world.”
A young person who is “Not in Education, Employment, or Training”. The acronym NEET was first used in the United Kingdom but its use has spread to other countries including Japan, South Korea and Taiwan.
In psychology, the Stanford prison experiment suggested that people who are immersed in certain environments tend to shift their behavior in accordance with the role, despite ordinarily not acting in such a manner. Currently, as much as it pains me to say it, I am living the life of a NEET. My primary interaction with others is through the internet and I spend my days mostly consuming. It’s charming in an odd way– in a “how the mighty have fallen” sort of way. The kind of way where you know that you will look back and laugh at how you got so accustomed to your dimly lit room that you had to wear sunglasses to run to the grocery store in the clothes you slept in so you could have enough milk for breakfast.
That’s what it is like. My days can start at 8pm and end at 3pm… and I can spend it entirely in my bed playing my Playstation Vita simply because I can— zero obligations. But do I enjoy it? Only to the point that I recognize what a sardonic regard I will hold for this phase of my life in the future.
For now, I try to keep myself occupied. I often find myself wondering what people do with all this time. I make personal projects up for myself and take respite from continually consuming by creating instead. Paradoxically, having boundless free time has dropped my productivity significantly in the way that in my mind, I have eons to get things done; emails sit unreplied to, papers remain stacked on my desk, but I continue working to accomplish the projects I want, no matter how small-scale they are. If one enjoys something and has no other pressing matters, it cannot be called a “waste of time” or “busywork”. Even if one might consider another’s photography of still life or illustration of nameless characters “useless” or a “chore”, it ends up being quite the opposite if the creator takes pleasure and pride in his work.
Despite this, I am not simply biding my time with no end in sight. Aside from taking time to sort out my new direction, I have begun the application process to certain programs I am interested in– a process that, due to the timing of things, involves a lot of waiting.
– The Future and Beyond
Those who know me well are aware that I am a rather effective planner. While the majority of the things I do are completely impromptu, when I do plan things out, it is done so in such a detailed manner that numerous contingencies are also accounted for. It should be a testament to my value of the future that this section of the post has the greatest length.
So I have not yet talked about my feelings about what career I should pursue now that I have withdrawn from medical school. Well to decide that, I had to first consider why I settled on wanting to become a doctor and what I had hoped to get out of it. Oddly enough, I originally wanted to be a programmer of some sort, but realized as early as high school that I would not want to program as a career– only as a hobby. What drew me to computer science was the “problem-solving” nature of the field, namely the numerous approaches one could take to solve the problems (some more elegant than others). What deterred me from the field was its reclusive work environment and the inability of end users to understand the beauty of what you had accomplished outside of acknowledging that the software was no longer “bugging up”. Prior to entering college, I tried a different approach.
I always loved science (a passion that feels foreign to me these days, I’m afraid) and found a scientific analog to problem solving that I thought I would enjoy: medicine. Not only would I have a chance to apply my scientific knowledge, but I would be able to do so in a very humanistic setting; I would directly be able to make others feel better. Because of this, I always intended to go into Primary Care medicine, meaning that I would have seen patients in a clinic instead of doing surgery in a hospital. The prospect of having my own clinic seemed exciting as well.
The problem is, healthcare in the US is changing. It is already difficult for a doctor to have his or her own clinic without working in a group and because of more stringent insurance payouts, doctors have taken to cramming as many patients into their schedules as possible instead of spending a decent amount of time with them. These days, the role of the doctor is more commercialized– they get in, listen to the patient, write some notes in the chart, and move on to the next room. The loose ends are tied up by nurses and physician assistants. In fact, more clinics are starting to employ autonomous physician assistants or nurse practitioners to see patients with the doctor merely signing off on their work. The last time I went to the “doctor”, I was only seen by the nurse practitioner.
In essence, the role of doctors is becoming more administrative– or rather, like “team managers” who constantly try to come up with initiatives to move larger and larger volumes of patients through the system to try and maximize profits. With insurance penny-pinching and with an increasing amount of Americans becoming insured, clinical practice has become more about “customer satisfaction” and crunching numbers than actually spending time with people to explain what is happening with their bodies. Most of the doctors I served with left their offices at 6:30pm with a stack of charts in their arm as “home work” because they would always try to see more patients than they had time to write notes for.
If I think about it objectively, without the tunnel vision I had aimed towards “getting into and through medical school” for so long, I suppose that I was getting disillusioned by these changes on some level. What made it worse was that most of the aged faculty continued on their education as if healthcare was not changing and that students could expect the same level of autonomy in the future. Not so. Ask any young, practicing doctor.
Because of its nature, one has to fully commit if one wants to become a doctor. I am not saying that it is an unfulfilling job in the least, but the road to becoming one is quite tough and demands sacrifices one has to be willing to make. It is not difficult to see how the vision that motivated me to follow the path of medicine has come to differ from reality, and as such I no longer felt that my aspirations were in line with what I would have to commit to. Perhaps if I were a decade or so earlier.
So now that such a vision no longer exists in the current market, what do I value and hope to get out of a career? Having given time to think long and hard about the things I desire, here are the points I came up with:
- Financial stability, both for me and my family
- A place where I can utilize my potential and my love for science
- A career that I can excel at, rather than limp through
- A means to make a notable difference in the lives of others
- An environment where I can interact warmly and with a privileged, personal regard with others
- Space to “run my own show”, i.e. the flexibility to do things on my terms
- A job that gives me enough free time to spend time with my family and participate in my hobbies
- A job that I look forward to going to and excitedly telling my spouse about when I get home
I admit, it does sound a little fantastical, but that is to be expected in a dream, hm? A lot of my “ideal” lifestyle is inspired by Dr. McCoy’s character in Star Trek— not only was he a passionate doctor, but he was also a warm, caring, friend to his patients. Looking at the list above however, I realized that I am still happy to pursue a career in health care. I never wanted to become a doctor for the prestige or title– I just wanted the autonomy and to be in a position to help others. With American healthcare changing, there are other positions that are starting to fulfill that position.
After considering my options, I decided that I will now pursue becoming an Advanced Practice Registered Nurse. The way thing are going, it is now becoming the role of such nurses and physician assistants to do the hands-on care with patients while the doctors take a more management role. Basically, the nurses are the ones who work with patients most directly– they are the ones in the front lines. Advanced Practice nurses have the ability to prescribe medications and even run their own clinics, all in addition to their normal duties of doing the “hands on” patient work; the increased autonomy can be owed to the Masters degree required to obtain such a job.
Those motivated by the chance to make a difference in patients’ lives find they have more meaningful contact with patients as nurses than doctors or PAs. It’s usually the nurse who makes the biggest impression on the patient and his/her family and who helps address a patient’s emotional and physical needs. Compared to physician’s assistants, advanced practice nurses often have a broader scope of practice as well. — January 16, 2014 | Written By: Roseman ABSN
Granted, a nurse practitioner would never be called to make the final say in a complex treatment plan or directly order a critical patient into surgery. But I would willingly give up being at the tip-top of the hierarchy if it meant being able to practice tangible medicine rather than a desk full of paperwork. To be able to do that while having more flexibility in free time while still receiving a comfortable pay– it sounds like a good deal to me.
While such a career alone would fulfill almost all of the bullet points I listed above, what if it is not enough? Well, here is where I expect the increased flexibility in hours to be an added blessing. With a Masters degree in hand, I would be qualified to teach courses about nursing on the side; a lot of higher level healthcare workers do this. After all, I have stated numerous times that I enjoyed my time teaching during undergrad and I think it could serve as a fun little stage to teach students about real world experiences in the field.
What I’m saying is that a career in nursing would give me room to breathe– enough room to do something I love, make a difference, and still enjoy life at home.
So here are my thoughts, organized and hopefully easy to follow. As must be obvious, there is a lot on my mind– the past, present, and future. The thoughts running through my head are messy, but far more organized than they were a month ago. Here’s to hoping that they, along with everything else, shape up with time. Thank you for all of your support.