One Morning in Maine: Why I don’t miss practicing medicine

One_Morning_in_MaineIf the world were merely seductive, that would be easy. If it were merely challenging, that would be no problem. But I arise in the morning torn between a desire to improve the world, and a desire to enjoy the world. This makes it hard to plan the day.

– E. B. White

This is one of the variations on a famous quote by the author. It is commonly referenced here on the coast of Maine, presumably because E. B. White lived nearby and, more importantly, because the mornings in Maine are so inspirational. [Ed note: E. B. White lived in North Brooklin, ME for the last few decades of his life.]

Yesterday, while riding my bike for exercise, I stopped to chat with a neighbor. He is a retired judge and occasional golf partner. He expressed surprise at my “Gap Year” plan and my retirement from private practice.

He assumed that my personal identity and professional identity were inextricably entwined, as were those of his brother-in-law, a family practitioner. He asked me if I missed my practice.

I did not skip a beat. “Not a bit,” I replied.

My Gap Year is to define a new relationship to time, space and family

He opined that I was likely to become bored, as he did after his forced retirement. He now does some part-time administrative judging. I pointed out that is what the Gap Year is all about. It is to allow me to define a new relationship to time, space and family. I will find something useful to do but it will be something other than private practice.

On reflection, I do miss my patients and I do miss my hand-picked group of colleagues, particularly my partner, who practiced with the sense of devotion and care that I did. I do miss my former office staff.

But the sense of relief that I am no longer trying to function in the most sophisticated, complicated, and yet dysfunctional healthcare system in the world is indescribable and far outweighs my sense of loss.

Enjoying vs. improving the world

For forty years I tried to “improve the world.”

The last ten years included my work as a trustee trying to nurture the hospital to which I had devoted my career. I am surprised at how easily I can let it go and more surprised at the anger I harbor toward the doctors who game the system, the administrators who perpetuate the system and the organizations that abuse the system.

When Lord Melbourne advised a young MP, to “try to do no good, and then you won’t get into any scrapes,” he did not mean to say “do bad things.” He meant that the willful act of doing good was likely to lead to unintended and unpleasant consequences.

For a year I will enjoy the world.

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