Walking away from my scrubs and scalpel has been one of the hardest things I’ve ever had to do. I started medical school when I was 21 and residency when I was 25. I spent 80+ hours a week for 51 weeks a year for 6 years—that’s 24,480 hours—learning to be a critical care surgeon. I spent another year doing research in the middle, and about as many hours again in my first 6 years in practice.
In his book “Outliers”, Malcolm Gladwell says it takes 10,000 hours to master something. We surgeons hit that benchmark in our first two years of training, and yet are just rookies with a “license to kill”.
Needless to say, I ate, drank and slept surgery. I put my life on hold and went all in. I alienated friends and family. I was terribly self-conscious of my lack of interesting conversation in the rare circumstance I had a social engagement with a ‘normal’ person.
As I reflect on my early days, there were many mistakes I made—most because I was young, inexperienced, and not mature enough to navigate the complex and critical situations. Those issues, compounded by the expectations and self-imposed pressure, created a very different Dr James than I am today.
The first red flag came during my 4th year of residency. I started having massive panic attacks. I could barely function, and it took every drop of energy to compensate and cover it up. By the end of each day I was so exhausted that I collapsed as soon as I got home.
I considered leaving surgery, but what would I do? I was 28 years old and $200,000 in debt from medical school, but was unemployable. I told no one, and barely survived my last two years of residency. My first job out of training was Assistant Professor of Acute Care Surgery at the University of Minnesota. There was a crisis of conscience after the first year–I realized I wasn’t just unhappy, I was miserable.
I felt a slave to the call schedule–my life was not my own. Was it my job? My career? Or was I just depressed? The long winters in Minnesota had to be eliminated, and so did my job. I remember the day I resigned I told my boss, “If operating doesn’t get less stressful soon, I may not be doing it long.”
My next job can only be described as a comedic failure and lack of standard operating procedure, the likes of which I have not seen before. I will save that story for another day. But, after 5 weeks I resigned.
I had some very difficult conversations with God, asking if I was just not meant to be a surgeon. I did not get the answers I was seeking, but it was almost mentally my undoing. I worked at two more hospitals, trying to find a place I could make things work.
Finally, in July of 2016—after six years practicing as a surgeon and eleven years in the field of surgery, I surrendered to the reality this is not my long-term path. I finally accepted that I was a very ‘square peg’ trying to fit into the very ‘round hole’ of surgery. Crushing guilt has weighed me down. I took a training position, and now I’m not contributing at a time when there is a shortage of surgeons.
I must be weak, or lazy, since most surgeons just suck it up and keep going. I’ve also wrestled with anger. I gave up my life for my career, now I have no career, and no life. (But, I still have my flair for the dramatic!).
Let me pause to interject one of my favorite sayings here: “Prayer is you talking to God, and meditation is listening for the answers.” The level of exhaustion that accompanied this process was indescribable. I felt like I was on a roller coaster and couldn’t get off. My life was living me. I could barely function through the day, let alone rest, meditate and listen to the Universe and its infinite wisdom and guidance.
Creativity requires white space. I was in a field that looked down upon you if you were less than ‘crazy busy’. It’s hard to imagine and create when you’re just running to keep up. So, why the heck did I become a surgeon in the first place?
The reality is, I loved learning, and the surgeons I trained under at Mercy were inspiring. As I compare my training to the current standard I see at other hospitals, they are a group of exceptional people who have a commitment to integrity and their patients.
At the time I came thru, a surgeon would have a wide variety of cases on the schedule for any given day. They were commonly with us at night, teaching and dealing with emergencies. Their explanations helped contextualize a mountain of data so we could make good decisions. They were doctors first, surgeons second. They took care of their patients completely—not just operated and ‘signed out’ to someone else.
My critical care fellowship was among my favorite times and experiences. My team of surgeons at the University is included in my list of exceptional people. They demonstrated leadership and excellence in academia, and taught me to navigate the politics of the hospital systems a little better. My night shifts at the University and the confidence I gained were invaluable.
I’m sure there are some who see my story and believe some tragic disaster must have happened at my hands to prompt my quitting surgery. Of course, there wasn’t. I am actively working to remove my concern of what others might think. The biggest concern I have, and that I haven’t fully worked through, is that the surgeons who invested in my training will see me as a disappointment.
Why share my story? As we navigate tough experiences that life hands us, it’s common to think, “I’m the only one”, or “there’s something wrong with me to cause this to happen.” The isolation caused when you become an outlier of the profession is devastating. I have read a handful of articles about anxiety and depression from surgeons, and realize for every person talking about it, there are hundreds for thousands of people going through the same thing, most of whom suffer in silence so as not to face the same trials faced by those whose stories are not so private.
I have always felt that my path was led by the divine, even during the tough times. I try to remain open to possibilities, and realize that the limits imposed by the medical profession are not real. You CAN change careers. You CAN try new things.
Being a doctor requires infinite curiosity and lifelong devotion of learning—these skills are helpful in anything we choose to pursue. This interesting journey has exposed me to pockets of fascinating medical knowledge that I’m diving into and can’t wait to share. It has opened my eyes to biohacking and ultimate performance information; and I am starting to realize that few people turn to traditional medicine unless it is a crisis.
I have a very real perspective on what we do as physicians and our limitations under the current operating system. I’m learning to break thru these barriers and am excited to show others how, once I find the right path. For the people who have lived the surgeon’s life more elegantly than I have, much respect from me.
To every doctor and healer: I’m sending you love and healing. You deserve happiness and you are appreciated by many whose lives you impact. To anyone who is struggling to find a place, you are not alone. There are always more options than we can imagine, and it’s never too late to make a change. Follow your gut and live happy.
For now, it seems the next part of my journey will be living authentically, helping other healers rediscover and embrace their value and worthiness, and promoting self-healing so that we might all become the best versions of ourselves. And I’m still trying to decide what I want to be when I grow up.