I’ve started reading about “the work” in Loving What Is and I am pumped about it. I feel like it applies to the struggles I have been having for so long about my profession. I have this feeling that I don’t like being a doctor, or that I don’t want to be a doctor. And yet here I am, nearly completely done with my training and apparently in position to begin my… “medical career.” What am I doing? This has been such a hard question for me and I feel I have simply dodged it for so long. Maybe it’s that I’m embarrassed of bringing it up with friends, or I just think that they wouldn’t understand. It’s too complicated, too nuanced. Well… that’s what this blog is for. Why don’t I like medicine, and what am I really doing here? Is it all momentum and no brakes?

I just finished streaming a board review course. I had a hard time focusing. I had made a priority to set the time aside, but I sat there with my headphones in and with my thumb on my twitter feed. I was watching news on the Kavanaugh story come in. But I’ve always been bored by medical articles. The AAFP articles just aren’t that interesting. Part of being a doctor is being able to slow down and interpret this boring stuff on behalf of my patients.

Why did I go in to medicine? I envisioned one-day spending time listening to my patients and help them to make decisions. They come in with a problem; I have training that helps me to help them with their problem. Now comes the curveball, through my training I have increasingly identified the pro-corporate-interests lean over the structures that rule my profession. The vision that I and many people hold on to of a caring physician developing a personal relationship with their patient and making decisions together in the patient’s best interest is now an illusion (from my perspective). I work in this system that supports the systems interests at the expensive of myself (the physician) and the patients (the real victims). I am afraid that this story I see has the power to end my career (paranoia) because in the competition of energy, the dark forces can see through me. My uncertainty leads to amplified and exaggerated fears.

But in publishing my thought here, I am spreading the word that things are not as they seem in the medical world, and that there are doctors who are figuring it out. I imagine a bridge, and I find it so difficult to be the bridge between worlds because the farther I go towards what I think to be the truth, the less comprehensible I am to my colleagues who I feel I am leaving behind. I think that by staying closer to the system, I am not going down the road towards the truth. I am speaking about the truth of myself. It’s the insight that comes through meditation. It’s about unpacking and dispelling the myths around self, and then what’s left.

I put a bracelet on my wrist and a bandana around my neck because I like them. That’s all. I would like to clean up my apartment and to sort through my belongings. It never seems to happen. I am going back to work tomorrow after a break. It was a nice break. Today (and yesterday) I was thinking of all the things I did not do, and was suffering with regret. I was also putting this pressure on myself that I still might do them. Laundry. Practice questions. Preparing for my group visits. Applying for my license. Hosting a bonfire in 1 week. On and on the list goes. How much brainspace has to go to that? The right amount. I get stuck though, and I think I wheel around for too long.

Coming back to what I’m doing in medicine. Right now, I’m getting through day by day. I hope to end up with a board certificate and then to be able to move on. I had the idea recently that I don’t need to decide for myself what my career looks like. It’s not just a dream I pick out of the sky and then try to create. It can come from the world too. I can just adapt to a space for other criteria.

So one step is learning to do locum tenens jobs. There’s a question. Can I work on and off as a locums tenens worker and feel okay about it? The system needs family medicine doctors. I have gotten the training. I can show up in a town and offer my skills for a short term. There are companies that will set the whole thing up. I can earn 90-125 dollars an hour. This is better than a carny or a coffee shop job. They talk about a minimum wage of 15 dollars an hour. If I double that. double it again. 6x minimum wage. Obviously the minimum wage isn’t even 15, the specific numbers aren’t important, but the idea is comforting to me that I have earned a certain privilege. This is at the same time uncomfortable because of the stories about inequity and I can feel guilt over my advantage. But, well, I do have the 270k loans to pay back. That is a significant burden that I’m not exactly dealing with. I estimated that I am generating about 17k in interest each year or 50$/day just for my education. That is currently growing, and that is after spending 8 years of my life working in ways that have been damaging to me. Whether you want to quantify it as more than 80 hours a week, or just believe my story that it has not been possible for me to engage in a healthy relationship during my training. That story makes me feel like a suffering-but-noble monk. Do I like that story? Yes. Is that story true? Maybe not.

I had a flash of a bigger story that I have been holding on to for a very long time. And it’s the one that MY STORY is important. That I matter. That as I toil away on my self-improvement exercises, whether that’s medical training, or music lessons or physical exercise, whatever, that this project is really so important. And what I just poked at in a way that felt new, was that: maybe not. Maybe my life isn’t special or meaningful in a way that I have held on to so tightly for so long. It’s part of the American story. It’s part of my parent’s story for me. But maybe for me, I can let that story go? Because it doesn’t end my life. It doesn’t make my life less meaningful. I can still do the same activities. I can still play the guitar and study medicine without telling myself the story that causes the suffering. What is the suffering? It’s in the separation between the story and the truth. There’s this mental energy that’s going to entertain the story. The story gets repeated and repeated. It takes on a life of it’s own. And pretty soon, it starts to block out the reality. Processing power gets bogged down.

And how much of a problem is it FOR ALL OF US, in the age of social media to feel that we need to speak up. That we need to have OUR WORDS, be heard? We are trying to shape the truth. We are trying to control. Does it do any good? Then look at the monks who sit in silence. Meditation is trying to untangle the mind. Observe the thoughts.

Again, in my future practice I want to “hold space” for people. Coincidentally, my friend Sarah just sent me a video from JP that seems to be satirizing the concept (https://www.youtube.com/watch?v=8aPsZaQcBs4). But I would like to practice that in earnest. I believe that it may actually be harmful or confusing when he is making light of a seriously useful concept. On the other hand, it is probably a good lesson in humility.

But what is my path? I don’t have to envision it from the clouds. But I can poke around. I want to hold space for people. I believe in that practice because people have emotional processing that they need to do, and good listening skills can help with that. He made a joke about “holding space” for the TV as a kid. It was a good one. And it is great that he can bring some levity to the topic. It’s also important to identify the real skill and it’s value. Sitting with awareness and being present has that value, and it doesn’t need to be defended. The truth doesn’t need to be defended. It just is. We may have a society that attacks the truth, but the truth persists.

So, in sitting with people, I “help” them come to breakthroughs. I help them to make medical decisions, to process medical information. I want to be an integrative provider. I want to be a holistic provider. I want to help with nutrition and exercise and social support and help to minimize the meds. I have said that over and over for ages. My job in the system doesn’t allow for that. I order the meds, write the notes and move on. So can I do the $90/hour job? Or will it feel like I am serving the wrong masters? And if I serve my patients directly, will I be able to make that work financially? Those are the questions I am sitting with.

That’s it. I am sitting with them. I don’t need to do anything more with them right now. Tonight, I need to go to bed. Tomorrow, I need to go to work. This week… I need to go to work. One thing at a time.