How I Got My Medical Mojo Back
The burnout doesn’t have to win
Burnt Out? You Don't Have To Stay There
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Burnt Out? You Don't Have To Stay There – Click Here To Work With Me –
I used to stand in the shower every morning and mutter to myself, “Two more. Two more.”
Two more what? No clue. It was just “two more.”
Yes, it’s as weird as it sounds.
Weird or not, I had those daily two more conversations at two distinct periods in my life. The first was when I was a full-time doctor, something I’ve written about a lot.
The second was for the three years that I worked my “dream job,” a job which ended up being so soul-destroying I still get PTSD any time I see my former boss’s name.
I haven’t written much about that period in my life yet because it’s still a bit fresh. Suffice it to say, though, that I literally had a timer app on my phone counting down to completely arbitrary self-imposed goals.
“6 days since my boss last yelled at me.”
“84 more days till I hit my nine-month mark.”
“285 days until I’ve been here for 3 years.”
I was absolutely miserable.
I should have seen the signs because it wasn’t the first time in my career I’d been absolutely miserable. I’d felt the same way when I was a full-time doctor, for all the reasons you know about if you’ve been reading this blog for a while. Doctors are cogs in a machine built on their backs to make insurance companies richer. We face significant moral injury, huge levels of demoralization, and have to exist in a space where all of our agency is stripped from us—but where we still bear all of the responsibility if something goes wrong.
I was absolutely miserable then too.
In retrospect, in both cases the two more mantra was my brain telling me, in the subconscious way it could, that I was stuck. That I was counting down the days to something, to some sort of freedom.
The problem was, there was no freedom. I didn’t see a way out. I felt stuck.
Depressing, right?
Well, stick with me. This one isn’t a depressing post.
See, I no longer chant that particular mantra in the shower any more. I can’t remember the last time I said two more to myself — except I do know that the last time it happened, what was happening immediately clicked. I’d learned that that was my psyche’s Check Engine light — there was something in my life that wasn’t going right. Two more was, for me, a symptom I needed to diagnose.
Fifteen years later, I’m writing this blog while sitting in my window on a hospital ship in Sierra Leone. I’ve built a career I adore—one that lets me work on the things I want to work on, and still get paid to do it.
How did I go from repeating meaningless words to myself in the shower, to a life I truly love, a life I don’t want to quit?
First, the bad news: It took me 10 years.
But there’s good news: It didn’t have to. In fact, I’m deeply committed to it never taking 10 years for anybody else.
Ever.
In other words, I don’t want it to take you 10 years either. I don’t want it to take you a decade to go from being stuck to being in a career you don’t continuously want to quit.
So, to avoid that, here’s the path I ended up taking, condensed in a few steps.
(This, by the way, is the 50,000-foot-view outline of the path I take my clients through when they’re trying to make the huge, consequential decisions in their lives).
Step 1: Get clear on your Why
Many of us are raised with the idea that there are right and wrong ways to live our lives. What those ways are will be deeply culture-dependent, but, irrespective, there are values, identities, and paths that we embark on at 16 that must carry us through until we’re 86.
A deeper version of that idea is something I like to call the True Self fallacy—the fallacy that identifies who we are with what we do. “I am a doctor. I am a Christian. I am someone who always sacrifices themselves for the good of others.”
And look, if that’s who you are, then it makes sense that we end up under a showerhead muttering “two more, two more” to ourselves. If our identity is in what we do, we can never let ourselves re-evaluate whether what we do has stopped serving who we are.
The problem is, our lives and circumstances change: the things we face at 26 are different from what we face at 56. Chances are, 26-year-old you didn’t have aging parents or growing-up kids. 26-year-old you hadn’t experienced the sort of love, life, grief, and loss that 56-year-old you has.
Which means that some of the values that 26-year-old you had will still be the values that 56-year-old you espouses.
And some will not.
If Today You makes decisions based on the things that were important to Past You, then Today You will never get out of the hell that you, today, are feeling—even if Past You chose that hell.
Does that make sense?
The first thing you’ve got to do, then, is to get clear on the direction you’ll be pointing your life for today and into the future.
In other words, forget what Past You wanted. For the next ten years, what is your why? What is important to you? How much do you want to carry over, and how much do you want to leave behind.
Today, I’m giving you permission to leave behind anything that doesn’t serve you any more.
Step 2: Get clear on your What
Every consequential decision is a recipe, whose ingredients include what you bring, what the situation brings, and your Why from Step 1.
Let’s say, for example, that you’re considering quitting your entire industry and doing something else altogether.
The ingredients to this particular Decision Recipe, the questions that would lead to a clear decision, are:
What options do you have to choose from—and are there more than you think there are?
What absolute, 100% deal breakers do you have, red lines that you would never cross?
What marketable skills do you have to offer—and are there more than you think there are?
What are the Whys you’ve solved for in Step 1?
On the other hand, let’s say you’re considering (re-)entering the dating game. For this Decision Recipe, the key ingredients are flavored somewhat differently:
What options do you have to choose from—and are there more than you think there are?
What absolute, 100% deal breakers do you have, red lines that you would never cross?
What do you bring to a relationship—and is it more than you think it is?
What are the Whys you’ve solved for in Step 1?
And here’s the thing…until you’re clear on those four questions, every choice you make about your career or your relationships is just a shot in the dark.
And that, my friend, is exactly why we end up confused about the jobs we want to take, the people we want to date, or the cities we want to live in.
Following me so far?
Side note:
A quick side note on the “are there more than you think” questions.
Chances are, your first-pass answers to the four Ingredient questions are far too limited.
I’d put money on it. Because you’re human.
Let me tell you what I mean. A good number of my career coaching clients are in the health professions. And when I ask them what their marketable skills are, they’re often stuck. Yeah, they can cut, sew, diagnose, prescribe, and nurse. But those aren’t really transferable, are they?
So they hit that first question, and they come to a screeching halt. “I don’t have any marketable skills outside medicine,” they tell me.
And that’s far too limited.
To be a good nurse, doctor, chiropractor, veterinarian, they will have had to have developed a whole bunch of other skills: people skills, critical thinking skills, writing skills, math skills, marketing skills, and so on.
The problem is, they’ve been taught to view those skills as “soft”—as if they’re somehow inferior to, less than, the “hard” skills of cutting, sewing, and diagnosing.
What about you? What skills do you bring to a career that you’ve—even inadvertently—developed in your current career? What have your last relationships—even against your will—taught you about how to show up as a partner? What are the Ingredients you bring to this recipe? And are they more extensive than you think?
Step 3: Cook the Soup
I don’t have enough space to write about this one well in a short blog post, so let me just say this:
There’s a difference between throwing a bunch of ingredients in a crock pot and hoping the corn chowder turns out ok, and following an actual corn chowder recipe.
One of the biggest reasons we get stuck is that we’ve never been given decision recipes.
Think about it. In school, we’re taught to calculate a cotangent and an arcsecant, we can solve the quadratic equation, we can dissect the heck out of the green light in The Great Gatsby—but nobody has ever taught us how to make consequential decisions.
“Make a pro-con list.”
“Ask your friends / pastor / parents / partner.”
“Take a walk in the woods.”
“Flip a coin.”
Which is…insanity. Our lives are literally made of consequential decisions. And we’re left on our own.
So, Step 3? Find a Decision Recipe.
(Shameless plug: you can read more about my Decision Recipe here.)
Step 4: Make a Plan to Act
Here’s an unfortunate reality: A decision is only as good as the action that comes after it.
In other words, you could go through all of Steps 1–3 and decide you want to quit your legal practice and open a cabinet-making business.
First of all, amazing! Congratulations! You’ve gone way further than so many other people.
And now, the real work starts. It’s all well and good to decide you want to make cabinets. It’s another thing to actually do it.
Make a plan to act.
Take a weekend to sit down and write out the actualities of this decision. Answer questions like:
What don’t you know yet about cabinet-making and how can you fill in that information? Whom should you be talking to?
Have you involved your loved ones in this decision yet? (Hopefully, but if not, do it now).
What does your financial runway look like?
How do you start branding yourself?
What does your CV read?
Where do you physically start showing up? Are there cabinet-making expos near you that you should go to?
Step 5: Get clear on your When
OK, last thing.
Set yourself a trigger day. With the financial runway in mind, with the details you’ve gotten from the cabinet-making expos, what is the exact day you’ll turn in your resignation to focus full-time on your cabinets?
The exact day.
Not a nebulous, future day. The exact one.
Write it on a post-it note. Put it on your bathroom mirror, on your computer screen. Some place where you’ll see it every single day.
Having trouble figuring out the exact day? That’s because it’s never the right time.
And that’s ok. There’s a way to decide when to act anyway. I wrote about it here.
Remember, as always, that the goal isn’t to make the perfect decision. It’s to make a good one. And that’s what these five steps will achieve. Follow them perfectly and you will make a good decision.
I’ll admit, though…these are hard to do by yourself.
Which is why I have one final recommendation: Get mentorship.
What got you here won’t get you out. The patterns, thoughts, actions that got you to a place where you’re considering making a big change are not the patterns, thoughts, and actions that’ll get you out of that place.
Because nobody is good at calling themselves out on their own ish or at spurring themselves forward when they’re getting in their own way.
You need someone who’s been there, who’s done it, and who knows how to walk with you through it.
The late Dr. Paul Farmer, a leading light in global health, talked often of accompaniment—that the best way to do global health isn’t to have someone parachute into Liberia to tell Liberians what to do, and then to disappear back into the ivory tower.
It is, instead, to walk with. To accompany. Another friend of mine says, “I don’t want you to give me a fish and I don’t want you to teach me to fish. I want you to wade into my river and fish with me.”
You need accompaniment.
Because you can do this. You can create a life you don’t want to quit again.
All it takes is doing it.
Did this blog hit a nerve? Are you stuck and not sure how to move forward? You aren’t alone. Let’s talk about getting you to a life you’re not trying to quit every day.
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