How Many Working Hours Do You Have Left In You?

The Dwindling Work/Life-Candle

There are rare, and I mean rare, individuals out there who can endure a 30 year career in medicine working a hectic schedule, dealing with constant changes in administration as well as balance a healthy family-life along with their own personal physical and mental health. I only know one person like that but apparently they are out there because as soon as someone dies they are hailed to have been that exact person.

An Ideal Lifestyle by design Scenario.

I believe as doctors have the luxurious option of living a high quality, intentional life. A life that starts out with very hard work, sacrifice and dedication. Interrupted by a few years of very long work hours in order to pay off loans and establish a savings. Then comes the wind-down years followed by lots of medical mission trips or local volunteering as an attending. It’s such a romantic thought to me, practicing medicine for free, providing medical care for those who cannot afford it.

Your medical education years should be completed by your later 20’s. Your 30’s spent working 60-hour weeks and you should be able to blow out that 40th candle as you start your winding down. Early in your 40’s you could either be working a few times a month or working locums in various parts of the world. In our mid-forties, you and I should be dedicating our time to teaching, volunteering medical expertise or helping out others any other way we can.

Now, what if some of you out there are angry little scrooges? Well, I don’t think anyone starts out as a scrooge. Scrooganism is a byproduct of too many years worked, opportunities passed up and a life filled with valid regrets. How could a 40-year-old financially independent doc be unfulfilled? Miserable, greedy or burnt out? Barring unfortunate life circumstances, that doc will be content, satisfied, giving and she or he will likely have plenty of energy left over to maybe even start a whole new chapter in life.

Life energy that you preserve is Positive energy you can donate to others

We spend a few extra hours than the average kid in college studying, even if you don’t want to admit that you were more studious you certainly were more determined, organized. That takes mental energy… which equates to life energy, a finite amount of cosmic ATP’s. We follow the college years with medical school, followed by some intense hours in residency. Sure there are many others who work long hours in their profession, yet medicine is different. Very rarely does anyone outside of medicine work so hard, for so many years, with so little sleep, with so much concentration and with the constant fear of making a morbid mistake. Finally in our early 30’s we start work in ‘the real world’. We don’t exactly get the best slice of pie there either; sandwiched between lethargic unionized nurses and bureaucratic dicks, telling us about HEDIS measures.

When you’re in your 30’s it’s all groovy. You can maintain. You’re in pseudo-decent shape, not great but you’ll pass for healthy. Your home life is doing fine, stressful and you’d ideally not have to deal with it but ya gotta. Practicing medicine is still good but it has lost its luster. The patient’s faces and personalities fade behind fears of lawsuits, patient complaints and long hours. You start slowly looking for ways out, perhaps flirting with patients, or ogling coworkers. The thought of having to work for another 20 dispassionate years makes you start looking for an escape. Getting plastic surgery done doesn’t quite do it, that Porsche or Range did it for a few months and that new house was a pretty good distraction for the first 1.5 years. But because you ignored your ever-dwindling work-hour reserve you are now running on E and it all just crumbles down.

Just Because It’s Long Doesn’t Mean It’s Good

Career longevity is like any other quantitative value, either long & satisfying or long & grueling. I used to revere those doctors working long hours, practicing well into their later years. Dr. T was 79 when I left my previous practice in San Diego. He no longer would work long weekend-shifts but regularly did evening shifts, probably 20 hours a week, not for the money, but because “if I stop working I’ll just curl up in a corner and die”.

Pushing Past It Just Because You Can And Because You Have So Many Other Times

A human being reaches a point where they know that they no longer have a passion for something. We can usually push past this, spending a couple more years in misery, followed by the death of that resistance within us. After that it actually isn’t too hard to stick it out for another few decades. However, what happens next is that this lifestyle of medicine becomes a part of you, leaving it will throw you for an unpleasant loop. If you do indeed leave it successfully, what will be left of you? Probably not much of a productive person, maybe someone who needs to rest and recover for the next few decades, just to ‘awaken’ at age 73 realizing that shit, you’ve thrown your last few away.

Perhaps there is a correlation between touching a patient’s life and career satisfaction, longevity and preservation of your work/life-energy. A cardiothoracic surgeon who gifts decades to an otherwise dying person probably expends this energy differently than the urgent care doctor who constantly repeats “it’s just a viral cold, you’ll be fine, believe me, in a few days this will pass and you will feel great, you don’t need abx”. Or maybe that’s yet another doctor thinking the grass is greener on the other side.