A Physician's Journey


I'm reading a very interesting and intriguing book called "Life is in the Transitions" by Bruce Feiler, and it has confirmed everything I have come to understand, intuitively in my body, and intellectually in my mind, about life change. Your life is marked by multiple transitions, and they average about every 4-5 years. The most common one we hear about is the "midlife crisis," but if you look at your own life, you will recognize those points along the way that marked a transition, perhaps mild and easy, or perhaps severe and difficult.

How are you with life transitions? Have you had a steady, linear trajectory with your career or your life? Or have there been some bumps in the road that have caused you to deviate from your anticipated life path? Have you come to a steady-state period of contentment, or are you noticing some discontent that makes you itching for a change? What would you say is the shape of your life?

Exercise: Draw your life as a line; mark the ages where you experienced major life events or transitions. How many have you had? When was the last one? What do you remember about your mindset at the time you had those transitions?

My own life has been marked by multiple transitions, some easy and some more difficult. I knew I wanted to be a doctor, so many transitions just happened without my really having to do very much (following the path from high school to college to medical school to residency). But some have required intense reflection and courageous action (leaving a comfortable, stable job with life-long benefits and pension for an independent private practice with more personal autonomy but no long-term guarantees).

What I have recognized is the following:

1. There are transitions in life that are inevitable; some predictable and voluntary; and some that are unpredictable or involuntary.

2. Certain events in your life that Feiler calls "life quakes" happen; those are the BIG events that shake things up, such that you are forced make a change (like you get cancer, or someone dies...)

3. It is fear that holds most people back in these times of transition. The universe (or God, your higher power, karma- whatever you want to call it) creates a situation that forces you to make a change, in spite of your fear. And you must move into the fear, and make the choice to push through it.

As the title of the book suggests, life is IN the transitions. You do not move from one part of your life to the next without some sort of transition period. The transition is the "messy in the middle" phase. And this is where the learning and the growth happens. It's new, it's uncomfortable, it's scary, and it's exciting. It keeps your mind open to the possibilities. There is an excitement that is reminiscent of our early days in training.

Why do we fear these transitions?

Because we have been taught to expect our lives, especially our lives as physicians, to be linear. You go to medical school, residency, maybe fellowship, then job. Marriage, then children might come into the picture somewhere along the way. Then... what? Is that it? Are you done? Are you "there?"- the place you were striving to get to so that you'd finally and forever be happy? It is our own expectation of happiness in a certain stage of life that creates the discomfort and angst we feel when we are no longer happy there.

Exercise: Name a time when you said to yourself, "I will be happy when ________". What happened when you got there? How long did it take for you to say the next "I will be happier when______"?

I admit that I expected my career to be set after accepting my first job right out of residency. But after 5 years in my stable "forever" job, I felt like a cog in a wheel, with no personal or professional autonomy. And so I left that job for more autonomy, for more personal connections with my patients, for the ability to co-create the physician-patient relationship. And I thrived! But then, 15 years later, I again found myself unhappy. The autonomy that I had craved, and the deliveries 24/7/365 that I had wanted and loved when I started, became my ball-and-chain. It took its toll on me, as other parts of my life became more important. My life view, my appreciation of self, and my need for that elusive work/life balance became a force that I could not ignore, and I made a decision to transition from OB/GYN to GYN-only/Physician Coach. My recognition of my own difficulty with balance, perfectionism, and self-judgment set me on a path to want to help others with these issues too.

As we gain life experience, our view of the world, and our place in it, changes. So why wouldn't you expect that your life choices and decisions would change, and your future life path would meander? This is not something that should be viewed as negative, because, after all, everything we do in life gives us a new perspective and an opportunity to learn something. Even if it's a job you thought you would love, but then you didn't. Or a partner with whom you had everything in common at first, until you didn't. Or a career that you committed your life to for for 25 years, but no longer enjoy.

Once you realize that your life is destined to have multiple transitions along the way, you can proceed in your life with much more self-compassion, freedom of thought, and creativity. When you have an open mind to all the possibilities, you will not look at any experience as a failure, but rather as a chance to really find your true calling, and explore all the things in life that bring you joy.