Thankful

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This post comes after a several-month blogging hiatus. The break wasn’t intentional, but life has a way of carrying us forward in unexpected ways. The past few months I continued to write, but in a different genre. I drafted several novels. I have two fantasy series that occupy my imagination currently. I’m not done with them. Novel writing is a long-term project, like most things in my life. Yet, despite stories unfinished, the flow of my days has brought me back to this blog. Afterall, the doctorhood quest isn’t over. It begs the question of whether the doctorhood quest will ever be over as there is always more to learn, but that introspection can be left to the future.

The past few months oscillated between easy schedules with plenty of time to contemplate life and my least favorite part of residency, night shift. I’m gleeful to report that I finished my last scheduled night shift of residency last week. Of course, I’m in residency. Another week or so of nights will sneak into my schedule before I graduate. Such is the way of residency, unwelcome and unfriendly work schedules. I skipped Thanksgiving because I was on night shift. I celebrated Christmas on November 30 because December is a doomsday schedule in my residency program. I wrote this blog at 3 o’clock in the morning because my sleep-wake cycle was still upset from night shift despite a week of day shifts under my belt. Schedule challenges aside, December is a month of reflection and giving thanks. I find myself in an interesting place – seeing how far I’ve come while also noticing a long road ahead.

I have 7 months left of residency. I have a job for post-graduation (more on that in a future post). I completed the administrative hoops to get official physician’s licenses. I scheduled my last exam – the board exam. Once I pass the board exam, it signals that the past 9 years of training taught me what I need to know about doctoring…at least on paper. Completing those tasks is enough to be grateful for without needing to look below the surface or consider the complexity that made them possible. But giving thanks is more than checking off one’s to-do list. So, let me dive deeper into some of the things I’m most grateful for currently.

On the top of my “thankful for” list are the countless people who helped me get to where I am. Many of these people are unnamed and their time in my life was brief. Together they made me the doctor I am. I must first give a nod of thanks to my patients. They have taught me more than they know. To be a patient is to be vulnerable, and they navigated that vulnerability with bravery. Next, I give a nod to my professors and peers in medicine. Medicine is a team sport, anyone who tells you otherwise is lying. Every day I learn something from my colleagues in medicine. Collaboration for the better good is one thing I love about the medical field. And last, but not least, I’m thankful for the friends and family who have supported me on this journey. They are the force that keeps me on the path forward. I will not imagine what this journey would have been without them. 

After the people in my life, I’m thankful for my circumstances. I’m thankful to live in the sunny city of Richmond where native passionfruit and pawpaws hide in the park. Where the river flows under and around osprey in the summer and ducks, geese, and cormorants year-round. Where snow falls occasionally in winter and daffodils bloom in February. Where cultures born of many pasts and futures come together, not always smoothly but always with hope. I’m thankful for my apartment where I can track the exact location of the sunset throughout the year – knowing the season by the building behind which the sun dives first. I’m thankful for the plants that dominate my living room. They ensure that there is no day without a flower blooming in my home. I’ve always said that I’ll know I’m rich when I can always have a fresh bouquet of flowers without concern for budget. When I thought of that definition of wealth, I didn’t realize that tending plants would make me rich faster than working. In retrospect, I should have realized that “wealth” is a nebulous term.

And finally, I’m thankful for my experience. My experiences on the doctorhood quest and in other aspects of life. I have never had a job that is as consistently rewarding and infuriating as being a physician. Most days the reward outweighs the frustration, which is why I continue to return. I had over 20 jobs before entering medical school, some were fun and others inspiring, yet I would not return to any of them. Apart from work, this year’s vacations, day trips, and glorious hours lounging I cherish. As December unfolds, I’m thinking about the experiences I’ve had and those ahead. There is never a dull moment when one accepts that the only constant is change. With the days of 2025 numbered, I’m thankful for what this year was and the hope next year holds.

Helping to Decode a New Language

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She wrote the number “8” smoothly. Months prior, it would have taken her five tries to get it. She was close to remembering all the colors of her home country’s flag. She wrote her name and birthday without issue – things she hadn’t yet learned when we started working together. Her English vocabulary was expanding. She understood simple words and phrases I said often during our classes together. Perhaps the progress was slow, but she was learning English and how to write.

For the past year I’ve taught English to a new American. I’ve taught English as a second language before, on multiple occasions, but she was my first student who couldn’t read or write. She was also my first student who couldn’t speak Spanish fluently. The lack of Spanish mattered since it was the only language I spoke other than English. She and I had no language in common, but we came together over her desire to learn English and my hope to teach her English. We came together over her desire to learn how to read and write and my belief that such knowledge is a human right.

Before she and I started working together, I’d never taught someone the alphabet or how to write. I found it interesting how her writing progressed just like children’s writing does. At first, her letters and numbers were large and sloppy. With time the shapes of the letters and numbers became more precise and smaller. At first, her spacing was off – she frequently ran out of room on our little whiteboard halfway through a word. Now, word spacing is seldom a challenge for her.

She impressed me with her focus and hard work. It was apparent she studied between our weekly classes. She studied English despite running a household and raising four children – three of whom were in middle school or younger. While helping her learn important things, like her birthday so she could fill out forms, I discovered we were born the same year.

Our life journeys have been different despite sharing a birthday year. Yet, our paths intersected over English. I wish that we could communicate better. I want to learn more about her. I want to hear her thoughts about the world. Perhaps, someday, we’ll be able to have such a conversation.

Patience with Patients

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The patient had stage 4 lung cancer which meant it was advanced. They’d already been admitted to the critical care unit (ICU) several times because they couldn’t breathe. There was one test to determine if the patient’s cancer had spread beyond their lungs pending. Given their rapid decline, I suspected that it had. The patient’s cancer doctors recommended chemotherapy. Yet, the patient wasn’t sure they wanted chemotherapy. When I saw the patient, they were taking a medicinal herb and a medication they bought online to treat parasites. They explained, not entirely incorrectly, that cancer is a parasite of sorts.

Autonomy is a guiding ethical principle in medicine which states that patients have the right to decide what happens to their bodies. I believe that autonomy is one of the most important ethical principles in medicine. I also think that it differentiates modern medicine from historical medicine. This patient’s story provides an example of autonomy in action.

On the one hand, my heart dropped upon hearing the patient’s plan. There is no research to suggest that the herb or anti-parasite medication they’d opted to take would slow or cure their cancer. There is robust evidence behind radiation, chemotherapy, and surgical treatments cancer doctors recommend to treat cancer. There was the hard truth that if this patient’s disease progressed as expected, they’d be dead within the year without science-supported treatment. There was a risk that if the patient waited too long before starting chemotherapy that they’d be too weak to survive chemotherapy treatment, making it no longer an option. On the other hand, chemotherapy is extremely hard on the body regardless of how strong a person is when they start it. And there was a chance that chemotherapy would make the patient feel terrible and fail to save their life or even prolong it.

When I saw the patient, they felt okay. They needed oxygen at night but, overall, were able to function almost normally. They’d taken steps to improve their health by decreasing the amount of alcohol they drank and the number of cigarettes they smoked. There was no research saying that the herb and anti-parasite medication they’d decided to take were harmful.

I collected my thoughts. My job as a doctor is to provide advice. My goal is to provide enough information so that patients can make their own informed decisions about their health. When I spoke, I acknowledged the dearth of research to support the over-the-counter treatments the patient had chosen for their cancer. I reinforced the truth that they had control over their body. I discussed the reasons their cancer doctor recommended certain treatments. I cautioned that there might come a time when they would be too sick to endure the treatments their cancer doctor recommended. I also reminded them that a middle ground was possible where they took the herbs and medications they chose on their own while also taking the treatments their cancer doctor recommended.

The patient decided that they would think about their options while continuing only their current home remedies. It’s seldom that there is only one right path in medicine. I felt that the patient understood enough to make their own decision. I worried about the patient, but I also knew that they were balancing all aspects of their life while I was mostly focusing on their medical conditions. I, undoubtedly, didn’t know some parts of their story. Only they could decide the best course of action for their body.

The doctors I’ve grown to respect throughout my training are the ones who have patience with patients. I strive to be that kind of doctor – one who isn’t scared to have hard conversations but is respectful of the path patients chose for themselves. In the end, the patient with lung cancer’s life was only theirs to live. I would be there to offer advice as we gathered more information and time went on. I would be there to offer an encouraging word and support. But I was not the one living in their body each day as the end of their life unfolded. Their cancer was theirs, alone, to fight. And though I was an expert advisor, their cancer battle strategy was theirs to decide.

Remarkable People

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Movement at the periphery of my vision caught my attention as I sat at a stop light on my way to work. The movement was a person standing on the sidewalk. Perhaps they were dancing in their mind. Their movements were rhythmic but not in the way most people move to a beat. Something was wrong. Then I realized they were foaming at the mouth and a string of drool hung from their chin. Their eyes were open, but I wasn’t sure they saw the world around them. The explanation didn’t take a medical degree to deduce: Drugs. Likely cocaine or another stimulant. Opiates make people sleepy, not interested in dancing on a street corner.

That day in clinic I had a new patient scheduled who hadn’t been seen by a doctor in several years. The patient was young. They had a history of substance use disorder. The last notes in our system, from several years prior, said they’d stopped using drugs. Previously, they’d used almost every class of drug: alcohol, tobacco, cocaine, benzos, and opiates. As I waited for their appointment to start, I wondered how they were doing, now years later.

The patient entered my clinic calm, clean, and collected. They were articulate and respectful. They had cool hobbies including gardening and beekeeping. “Last time you saw us, you hadn’t used drugs for a few years. Is that still the case?” I asked.

“Yeah, I don’t use drugs anymore. Haven’t for years. I still smoke cigarettes though,” the patient said.

The conversation about their health unfolded. I looked at my computer to go through the never-ending reminders the healthcare system required me to complete with my patients. The reminders for the current appointment included cancer screening and offering nasal naloxone (maybe better known by its brand name “NARCAN.” It’s a nasal spray that reverses the effects of opiates and, if given soon enough after an overdose, saves lives).

“I know you said you don’t use drugs, but I have a reminder here for naloxone. Would you like free naloxone just in case?” I asked.

“No. I’m good. I used to have it. It saved my life twice…and I saved the lives of two other people. I had a friend that said over his time, he saved 60 people with NARCAN,” the patient said.

“I’m glad you were able to do that. I’m glad you’re still with us,” I said.

I finished going through the reminders. We finished our appointment. The patient was healthy and didn’t even need any blood tests.

I thought about the patient as I walked to my car. Beekeeping is awesome. I hoped I’d get back to gardening someday too. As I put my car in reverse, I remembered the person I saw foaming at the mouth on my drive to work. The contrast between the person I saw on the street corner and my patient that day was stark. The contrast reminded me how life is nonlinear. I thought about how the patient had saved their own life and the lives of two others. The patient I’d seen was a remarkable person. The phrase popular for healthcare workers during the COVID pandemic came to mind, “Not all heroes wear capes.” I decided the phrase was accurate but needed modification. Perhaps a better phrase for remarkable people in the world is, “Not all heroes wear capes, but they have baggage and have learned to carry it with grace.”

I hoped the person I saw dancing to drugs and foaming at the mouth would turn down a different road in life. Maybe that person on the street corner would someday tend their own flowers and suck honey from honeycombs too. Maybe the person I saw on the street corner had saved a life right before I saw them. Maybe their life had been saved by an unknown remarkable person. Afterall, the only thing that makes people remarkable is what they’ve done. Every day each of us can decide to do something new. Every day we can evolve and refresh. That’s the most exciting thing about life: The only constant is change.

The Process of Learning Medicine Works

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I started my last year of residency on July 1, 2025. In the doctorhood quest, the days pass slowly while the years pass quickly. As time marches onward, I sometimes forget how far I’ve journeyed on my own doctorhood quest until an experience reminds me of where I’ve been.

This July I was reminded of where I’ve been when I had the opportunity to work with new third-year medical students. The third year of medical school is when future doctors start their clinical training – in other words, they leave the library and the classroom to enter the clinic and hospital. The third year of medical is a dramatic transition from learning theory to applying it.

I surprised myself this July as I answered third-year medical student question after question. No question was too hard – I could either answer by reaching into my mind or by easily referencing the resources I’ve come to consider my external brain. Not only did the answers come easily but so did the process. It was once hard for me to sort through patient data and make sense of it. It isn’t anymore. Work that felt overwhelming years ago – reviewing data, seeing patients, writing notes, and pitching medical ideas – is now second nature. Of course, I don’t know everything there is to know about medicine. I never will, which is one reason I love medicine. But, these days, it’s easy to identify gaps in my knowledge and easier to know where to find the answer. I know when to ask a colleague vs. ask a specialist vs. look the answer up myself.

I was a third-year medical student about 4 years ago. Now I supervise medical students of all levels. When I coach my students on how to improve the way they present patient information in verbal and written form, I’m reminded of how these things once were hard for me. As I help students review a new consult or a new admission, their questions and hesitancies remind me that I too once had the same uncertainties. These days when I work with medical students, it’s obvious to me that the process of learning medicine (student, then resident, then independent doctor) works. My own experience is a testament to that. I can’t wait to see what medical knowledge and healthcare wherewithal I’ll have after another 4 years of being a doctor. Stay tuned.

The Bitterness of Slow Declines

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They were miserable. It was obvious from the silence they kept as their spouse explained everything that had happened since our previous appointment. It was obvious from the frown on their face and the apathy in their voice. It was obvious because no matter how many things I mentioned that I knew they liked, they didn’t smile or brighten once.

They weren’t excited about their new hearing aids which enabled them to hear birds again. In fact, they often didn’t bother turning the hearing aids on, per their spouse’s report. They were afraid to go outside for fear of falling. They couldn’t change a lightbulb because they felt weak and dizzy.

They had once been the person everyone in the family relied on to fix things. They had once been the advice giver. They had once been able to keep up with even the most social of butterflies. They had once been independent – free to run errands and tend their lawn without supervision. And now, they were none of those things.

The patient had tried therapy. We were always optimizing their medical conditions to keep them as healthy and functional as possible. The thought of starting another medication to help with depression was suffocating for both the patient and I because they were already on many medications. What was left?

Everyone who lives a long time eventually slows down. Some slow down and then die before developing medical problems that cause them to visit doctors and hospitals often. Others find that their social calendars fill with doctors’ appointments. Either way, or somewhere in-between, the transition from independent and fast to reliant and slow is hard. It’s an identity shift and a lifestyle change. The bitterness of slow declines is that they don’t ask permission. The body marches along, making changes that upend everything that came before, without giving time for the person undergoing the changes to accept or adjust to them.

I knew the patient was suffering and, yet, I didn’t have much to offer. I wanted to see the patient through this phase. Was it the last phase of their life? Probably. How long would this phase last? It could last days, or it could last years. It was impossible to tell. Almost the only thing I could do was acknowledge their misery. Call it what it was. I referred them to doctors who specialize in caring for the elderly. Perhaps those doctors had a secret for helping this patient. I hoped they did. Perhaps it was a secret I, too, would uncover.

At the very least, I stood witness. I knew who the patient was and who they had been. I acknowledged their struggle. At that appointment and the previous and the next, I listened to my patient for no other reason than to ensure that they felt heard. Listening wouldn’t change their situation, but sometimes the only thing I can offer as a doctor is a listening ear. And sometimes, that’s enough to help my patients make it through until our next appointment. Occasionally, it’s enough to make my patients feel better. Such situations remind me that medicine isn’t always about medicine, sometimes it’s about being human.

Spying on Birds

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A flash of color. A movement out at the edge of my peripheral vision. A song so sweet it lingers in the mind after it’s done. These are the taunts of the birds as I try to spot them. Brown. Gray. Yellow. White. Black. Sometimes bright colors. Blue. Green. Red. Orange.

Birding, the act of watching birds, can be passive or active. In the passive form one simply observes birds that flit or swore on the path of one’s normal travels. In the active form the purpose is to see birds, discover their hiding places, and learn their names.

Growing up my mom liked birds and knew the names of most of the ones we saw in our rural home. My mom’s side of the family was a bird-loving side. As such, bird names – blue jay, cardinal, chickadee, hairy woodpecker, osprey, red-tailed hawk, wood duck, mallard, etc. – were part of my normal vocabulary. Just like, I imagine, brands or celebrities’ names were part of the vocabulary of other children. I didn’t know it was unique to know birds by name until I moved away for college. There I found myself on an urban campus where I wasn’t convinced that some of my colleagues could identify a live chicken.

Life unfolded. I stayed urban for a time. Then I moved abroad where there was too much to learn to also learn new birds. And then the doctorhood quest took off like an ultramarathon – slow and steady but always busy in its own way. Fast forward. I found myself in Virginia. Virginia and Vermont share many birds. And some of the birds Vermont sees only in the summer Virginia sees at other times of year. As I wandered the forest and wetland trails on my days off from residency, I started to notice the birds again. Somehow, having spent 10 years learning other things and more than that away from my childhood home, the birds I knew as a child resurfaced. Old knowledge was not lost despite filling my brain with an additional zillion factoids on medicine and the human body. Birds. I still know the song of the hermit thrush – Vermont’s state bird. I remembered the nuthatch and the tufted titmouse.

I have a good partnership. My spouse likes to take pictures of birds and I’m good at spotting them. My binoculars are my superpower. The only challenge is that when one starts actively spying on birds it’s hard to stop. My spouse and I now seek out birds on our vacations. I find myself toiling over bird books and using Merlin Bird ID.

Birding escalates. It starts with just trying to see birds. Then it’s about naming them. Then it’s about finding rare birds and memorizing new bird names. A harmless pastime. Another excuse to be outside. Another reason to love wild places. Another reason to also learn about the trees and plants that birds, themselves, adore. What fun it is to go on a walk and be able to name the birds, trees, and plants I see. Almost everyone used to be able to do that. Now it’s a dying art. Funny how the world changes. It’s never too late to circle back on the knowledge we once had. It’s never too late to learn something new. Just ask the birds migrating on ancestral routes and adapting to new cityscapes. They’re experts in learning.

Knowledge

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“People believe shit and don’t believe sense,” my supervising doctor said. The comment was in reference to patients who believe remedies without any evidence to support their efficacy will treat disease better than medicines which have robust research behind them proving they work. It wasn’t a comment saying patients shouldn’t believe or do whatever they want, it was a comment that each of us should challenge ourselves to investigate the facts behind claims. It was a nod to science – the scientific method designed to prove that observations are (or are not) significant.

Perhaps the statement wouldn’t have caught my attention in a different era, but with the state of current affairs it did. These days there are attacks on science. There are TV stations and online blogs calling themselves “news outlets” yet report nothing but opinion, and poorly informed opinion at that. There are threats against the true investigative journalist; stories based in research.

Current affairs. The thought that one can simply say whole groups of people don’t exist and think they’ll disappear…or assume they don’t have a right to be who they are. The assertation by certain politicians that experts know less about their industry than folks who never studied it or never worked in it. The propaganda that people who move from one country to another didn’t do so in good faith, didn’t have a dream for a better life, and weren’t needed in the country where they arrived. The dangerous opinion that one’s beliefs are the only beliefs; forgetting that we’ve proven time and time again that all humans are fallible and that diversity of thought and world view make our species stronger.

The ability to think critically and analyze the validity of people’s claims is a form of power. It’s powerful to set one’s emotions aside and examine the truth behind one’s feelings. With a critical approach we can gain knowledge, not just vibes. With knowledge we can grow and change. We can learn to better understand those different from us rather than expect everyone to be like us. We can embrace diversity. We can embrace transitions from one identity to another. We can include everyone. Knowledge helps us understand that prohibiting words like “diversity,” “transition,” and “inclusion” won’t make people who live those realities disappear and is a form of coercion and censorship. 

“People believe shit and don’t believe sense,” my supervising doctor said. I laughed at the comment because in the context it was funny. But it wasn’t funny when I thought about how many people have, do, and will suffer because powerful people are unwilling to believe sense. Unable to hear reason. Disinterested in knowledge. We can’t change other people, but we are responsible for ourselves. I challenge you to look for sense, not shit, when making your decisions in every facet of your life. If each of us challenged ourselves to do that, the world would be different from what it is today.

Positive Transformation

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The first time I saw the patient, they weren’t sure if they wanted to take the medications I recommended for lowering their cholesterol and blood pressure. Primary care appointments are conversations. My assessment of their health after reviewing their labs, vital signs, and story suggested that making lifestyle changes (like more exercise and diet adjustments) and starting a few medications would help the patient be healthier and reach their goal of living a long, healthy life. I explained the reasoning behind my recommendations and the patient agreed to think about them. We planned to continue our discussion of possible medications and lifestyle changes at future appointments. As I like to remind my patients, it doesn’t help anyone if I prescribe them medications they won’t take. I’d rather have an honest conversation about the medications I think would help them but only prescribe the medications the patient would like to try.

Primary care is proactive. In other words, the goal of primary care is to prevent the development of disease in the first place or, if a disease is present, to prevent its progression. Contrast primary care with the reactive approach of hospital medicine. The goal of hospital medicine is to treat disease that is unstable or so far along in its course that it can’t be safely managed outside of a hospital. We know we can help people live longer, healthier lives when they have good access to primary care. However, the challenge with primary care is that often the interventions it promotes don’t create visible changes in the present.

For example, people generally don’t feel any different if their cholesterol is high or low. However, we know that high cholesterol over time can lead to clogging of arteries which, in turn, can lead to heart attacks, strokes, and blockages in arteries that feed the legs (causing pain, poor healing, and tissue death). If a patient has high cholesterol and chooses to lower their cholesterol through diet, exercise, and (possibly) medications they are taking important action to prevent heart attack, stroke, and the other complications of clogged arteries. Yet, it can be hard for people to find the motivation to change their lifestyle and (possibly) take medications every day when those changes don’t change how they feel, and the health benefits are intangible (though very real).

I saw the patient who agreed to think about my medication recommendations many months later. They had lost weight and looked more muscular. They’d revamped their lifestyle – they started a balanced exercise program at least 3 days a week and minimized sugars and carbohydrates in their diet in favor of lean meats and vegetables.

“I’m ready to try the cholesterol-lowering medication,” the patient said, bringing up the topic before I did.

It was a complete transformation. “What motivated you to make all these changes?” I asked.

“I decided I want to live a long time still. I have things I want to do,” the patient said.

I found myself smiling long after the patient left. Many people struggle to make all the changes that this patient had to support their health. Yet, this patient had taken their health into their own hands. And, while I’ll never be able to say exactly how their actions changed the course of their life, every bit of research suggests these choices would shape the patient’s future. They’d lowered their probability of dying from heart disease or stroke. They’d lowered their risk of developing heart failure and diabetes. And such a positive transformation, though rare, is the dream of primary care.

The Tired Mind

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The foundation of medicine is curiosity. Desire to understand how the human body works – how those workings can break and malfunction and then, how they can be fixed again. Interest in the human experience. Wonder about how the mind can influence the physical. Joy in the triumphs of human capabilities. Humility in the shadow of human limitations. Thrill in the story of each human life. Medicine is built on questions and the pursuit of their answers.

At its best medicine is cutting-edge. Exciting. Grounded in the clearest understanding of the world the best science has thus far provided us. Yet, medicine isn’t always at its best. Medicine, after all, is a profession performed by humans. And humans are fallible. Medicine doesn’t stand above or beyond bias and money. And physicians, like all human beings, get tired.

The tired mind is a weak medicine mind. The tired mind processes slowly. The facts stand right in front of a tired mind, yet the mind is too weary to see them. The tired mind makes mistakes. Rushes when it shouldn’t. Forgets. Gets distracted by unimportant details. The tired mind is more likely to cut corners. Tired minds place patients in boxes of diseases rather than notice the nuances that make each patient unique. The tired mind is about clocking in and clocking out. The tired mind doesn’t ask questions. Because questions must be answered. And answering questions takes time. The tired mind has used up its time.

I think about the mind often at the wee hours of the morning on nightshifts or when my dayshifts drag on in a string of events. Not necessarily unfortunate events but overlapping and clashing events that make up a typical day in medicine. As shifts pile on top of each other, the events of each shift blend creating fog within the mind.

I know when my mind is tired because medicine isn’t interesting during those times. When my mind is tired the wonder of medicine evaporates. The wonder is replaced with drudgery as many tasks become repetitive and the clock ticks. When fatigue prevails, work hours are reduced to time that feels stolen. Stolen in the sense that work hours become hours I can’t sleep, can’t see the sun, can’t visit people I love, and can’t do hobbies I enjoy. When my mind is tired work hours are exposed as time spent looking at numbers that almost tell the story of human existence. I know that life is more than the sum of the numbers that describe it but, when I’m tired, I can almost believe life is no more than numbers.

When my schedule eases and balance between work and free time is restored, the wonder of medicine returns. The thrill of seeking the answers to mysterious questions – the function of medications, the disease behind a constellation of symptoms, and the life experience that led a patient to the hospital or my clinic – takes center stage again. When there is balance and my mind isn’t tired, medicine is thrilling. Thrilling because few other professions let one spend their day unraveling mysteries. Hearing the stories of real humans and decoding what those stories mean from a wellness and health perspective.

As my days as a resident dwindle, I find myself thinking about what it will take to minimize the tired mind and maximize curiosity during the next phase of my career. It was my love of stories and my delight in solving riddles that carried me through the 8 years of medical training I’ve already completed on the doctorhood quest. One more year and I’ll be an independently practicing physician. Even if I’m called to do more training, no future training will be like medical school or residency. Nothing can be. Medical school and then residency are times of growth, but they involve too many hours spent with a tired mind.

I plan to make the next step not the way of medical school and residency. How do I find or create a job that serves me as well as my patients? How do I ensure my work fosters curiosity and promotes wonder? How do I make work more than task completion and income earned? How do I make sure that the formulation of questions and the pursuit of their answers remain at the center of my work? To answer these questions I must explore the nuances of the profession; a wholly different pursuit than gaining the medical knowledge required to become a physician.