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The Unraveling

6 min

Did I love medicine? Yes. Did I view my career as my identity? Yes. Did all this change after my daughter was born? Yes.

When my wife was pregnant with our daughter, it was not uncommon for us to hear phrases like “kids will change your life!” or something similar in that vein. A polite laugh, or a nod was our usual response. 

But, I’ll confess.

It didn’t hit how impactful having our daughter would be and re-orienting she was to the compass of our life, until we were holding her in our arms. In that one instant, holding her for the first time, I knew everything had changed. 

Fast forward a year later, and I was quitting my job. 

The following essay chronicles my journey of quitting medicine, and the catalyst behind it. To be honest, I’ve actually drafted and rewritten this no less than twenty times. I’ve pondered whether it was relatable, or if I was simply “therapizing” my experience. Perhaps a little bit of both, but I knew sharing would be enlightening to someone in a similar position. To be frank, I wish I HAD exposure to someone who’s been through balancing medicine and having a baby, because then, maybe…I would still have a job. 


I knew quickly in medical school, that having a balance between working and family life was a priority. It’s primarily why I chose the specialty I did: Physical medicine and rehabilitation, or PM&R. I loved everything about PM&R: the reward of seeing patients get better, the problem solving nature of the specialty itself, and the team-work aspect of collaborating with some of the best people I’ve met in my entire life. 

After graduating residency, I decided to take an inpatient job at a large academic institution, in Southern California. A dream-come true, in almost the literal sense. It had checked all the boxes I was looking for in a job, and seemed to be the culmination of a long and hard path.

There were aspects of the job that seemed arduous and challenging of course, but not unlike residency or any other corporate job (I thought). The call schedule was more intensive than what I was used to, and managing higher complexity patients was difficult, but left me feeling satisfied to expand the breadth of my medical knowledge. 


After my daughter was born, it seemed that time ceased to be a concept. It was painfully slow, yet fast and somehow unrelenting at the same time. Hours pieced into days, then somehow tumbled into weeks. It felt as if, when movies do the flash-back effect-thing with a soft hazy glow, but we were actually living it, our happy-little-family bubble. 

And then, it popped.

The fundamental change that occurred after my daughter was born, was it changed the way I view time. Prior to having my daughter, all time seemed like equal time. If I didn’t have enough time to do a project, I could always borrow it from another day. But what I began to understand was that time becomes the currency after having children. There’s no such thing as borrowing time, because once a moment is missed, it’s gone forever. And no momentary value will replace it. 

Growing up, I recall, my dad telling me, “time is money” but I never fully understood what that meant. I realized being financially comfortable meant nothing, if it demanded being away on most weekends, and being called multiple times a night.

Being rich, was not any sort of monetary value; but having the luxury to move through the day, unconstricted by being on the clock. The “biggest flex" was suddenly being able to go to the grocery store on a Wednesday morning with my baby, and stopping for a croissant and coffee. 

Residency and medical school has this weird way of warping what seems normal. For many, it’s normal to go weeks at a time with laundry stacking up, until finally there’s a “free morning” to shove all the laundry in the washer. It’s common to search months in advance for a “golden” weekend to grab lunch with friends (but only lunch, because inpatient wards are the next day). It wasn’t until we were holding life’s little miracle, that we understood how diabolical it is to live this way.


After I returned to work from paternity leave, I felt this strong calling to be home, snuggling with my baby, enjoying her coos, changing dirty diapers, and washing baby bottles. All of sudden, where I needed to be was home, and not in the office.

As my daughter grew older and started to learn to crawl and cruise, it seemed silly for me to be married to my job and to the field of medicine in general. Because ultimately, for what?

At the end of they day, my perspective had shifted: that work was simply work, and didn’t have to be anything more than an avenue of income to maximize the greater gift of having time to spend with the people I loved.

For as long as I could remember, I had reached where I thought I needed to be. I thought that my career, and my arc defined who I was as a person. After a decade of higher education and residency training, it’s only natural that our work solidifies an identity that we’ve cultivated so hard, it’s understandable. But after my daughter, no longer did my job have any authority over who I was painted out to be. The title that after my name was no longer “MD”, but rather dad.


The frustrating thought that kept coming back to me, again and again was: why didn't we have a realistic picture of this before? Why didn't we see healthy work life balance in residency or in medical training? Was there ever a balance that could be struck?

Do doctors that want balance, simply self select themselves out of the rat race?

The examples typically seen in training is the attending who puts work in front of their families. The long clinic hours, the lectures given in the evenings, over pizza, while their family eat dinner at home. The late night research meetings and the even later night combing of handfuls of abstract proposals. What I routinely saw was my own mentors sacrificing time away from family for the sake of the institution, the program, the mission, even at the sake of their friends weddings, their health, and their sanity. 

The biggest shortcoming in medical student education (in my opinion), is not receiving exposure to doctors, who don’t absolutely love their jobs. And, that should be ok. We should be allowed that experience.

I can’t help but think, that if I had seen examples of my mentors navigating a healthier work-life balance, maybe I would have chosen a different job out of training or even an alternative career path. 

Balancing raising a family while juggling the demands on being a doctor, is an experience that never is openly talked about. Perhaps for medical students or residents, it’s not core to an educational experience and honestly, why would it be? But maybe the reality is that all of us are struggling to find a balance, and it’s not easy, and it’s hard especially with babies, toddlers, kids, pre-teens, and teenagers and we’re all just trying our best. 


I ended up quitting my job a few months after my daughter turned one. It was an exhilarating experience, shedding a part of my identity that I had meticulously crafted for so long. It’s also been stressful (to say the least) knowing bills still have to be paid, without a regular paycheck. But I felt at peace, knowing I had made the decision not just with my heart but also strategically with sound mind.

Perhaps you’re in a similar situation, whether you’ve recently had a baby or maybe expecting another, or simply just facing the reality that your career is not your identity. Whatever the case, it’s an extremely hard decision and everyone has their own reasons why. My reasons may not make sense to some, but I would make sure those reasons are valid for you, your family, and those who depend on you. 

I share my experience because, I wish I someone else had done the same for me. I wish I knew about how heart wrenching it is to have to choose between your career and staying at home with your baby. I wish I knew about all the late nights, making decision trees and devising exit strategies. I wish I knew how it seems to only have a hard choice and an impossible one. Because in the end, all I wanted to hear was that it was ok; that I wasn’t alone in feeling this way, and it would all be worth it in the end. 

Paul,

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