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Sep 07

Happy Philosopher: The Backstory

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Of course I know where I’m going son

 

My ideas and philosophies did not develop in a vacuum, and the context of my life will likely make my writing more meaningful to you, so here is a cliff-notes version of my story. Note that the human mind is notoriously poor at accurately remembering events so this reality is my reality, but it may not be entirely true! Also note that my life is not that exciting so I apologize in advance if you fall asleep while reading this and wake up with an impression of a keyboard on your face. You have been warned.

 

Part 1: In the beginning

Although there are probably all sorts of interesting psychological scars to be explored from my childhood I don’t think there is anything too exciting to discuss here. Of course our personalities are shaped by these early experiences, but I think often times it is hard to dissect. I grew up part of a pretty typical middle class family. I feel my experiences were within the range of normal. (This isn’t to say there were no crazy things going on, but they were no crazier than anyone else’s.) So let’s start a bit later.

After graduating from high school I went to college not really knowing what I wanted to do with my life.  I sort of figured I would either become a doctor or a lawyer because, well that sounded like what smart people did…and I considered myself pretty smart at the time. I wanted to make a difference in the world and these professions seemed like they had the potential to have a big impact. These also, coincidentally, seemed to be professions that would provide copious amounts of money and prestige and, after all, who wouldn’t want that. I could save the world AND live a good life full of all the expensive, shiny things that I did not have at that time. These things bring happiness right?

I never really considered anything other than to go to college, meet a girl, get a job, start a family, etc. This is all I knew. It is all my parents knew. It was the only thing my friends were doing. Our reality becomes defined and constrained by our knowledge and experiences, for better or for worse.

Well, after a while I decided (more or less randomly now that I really reflect) I would become a doctor. I worked hard (kind of), got good grades, jumped through all the hoops and got accepted into medical school. Game on! I plowed ahead learning all sorts of cool things about human anatomy, physiology, pharmacology and psychology and had some of the best years of my life.  I met some of the most impressive human beings I have ever encountered and was humbled many times over by the diverse experiences that medical school uniquely exposes a person to. I made many lifelong friends, got married to what I would call my soulmate (if I actually believed in such a ridiculous notion) and experienced an existential crisis (maybe I’m being a little dramatic here) when I realized I had no idea what kind of doctor I wanted to become half way through my training.

I had figured I would become a psychiatrist as I was fascinated by the human mind; but after completing my psychiatry rotation I realized it was nothing like my preconceived notions had led me to believe. Additionally, as each of the other core rotations clicked by I checked them off my list as I could not see myself actually making a career of them. It is not a really happy place to be three years into medical school and have no idea what you want to be when you grow up. I eventually decided on radiology: Interesting, broad, and introvert friendly!

I pause here to reflect upon career choice. In retrospect I wonder how many of us actually choose our career, or if it chooses us.  Kind of like religion, morals and beliefs, how much is actually a conscious choice and how much is unconscious influence from our society, clan, friends and family?  How much is influenced by what the people we respect think? It makes one think a little deeper about how much free will we actually have. How many of our choices are actually an illusion?

Anyways, I digress. I plowed through residency and fellowship and absorbed as much knowledge as I could about my chosen specialty. I made more friends, met more cool and brilliant people and before I knew it I was ready to take the training wheels off and get a real job. I took a couple of weeks off to move and get settled, and jumped in head-first without really knowing how deep the water was.

If that last paragraph (which incidentally covers 6 years of my life) felt rushed, that’s because it is how it felt to me. Medical school felt slow. Residency and fellowship felt fast. Life sped up, kind of like I got on a high speed train with no choice but to go forward. Did I mention we had our first child somewhere on that train ride?

 

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Turning that knob will not end well

Part 2: Welcome to the Real World Neo

When I started my real job I was surprised at the pace quite honestly. In medical school the radiologists all looked relaxed, like a bunch of Zen-like Yodas shuffling around calmly spewing wise words into their Dictaphones. We would meander through the studies, discuss them, and maybe meet with one of the many services that would come down to the basement to look at the films with us. Yes, it was all film back in the old days. Private practice was completely different. There were constant stacks of studies to be read that seemed to materialize out of thin air. There were procedures to be done, phone calls to constantly make, questions to answer and much less face to face consultation with other physicians than before. Everyone seemed busier. There were fewer smiles and laughter. No one had time to come to radiology any more, and eventually everything was on computer anyways.  It was a grind, day in and day out.

But I adjusted. It was much more stressful but I got faster and more comfortable managing the stress. Some days were tougher than others, but everything was more or less manageable. We were busy. Life accelerated. Both Mrs. Happy Philosopher and I were working, and at some point we realized that this sucked, especially with kids. Two call schedules to juggle, child care to arrange, few weekends to ourselves that we didn’t share with the hospital. This was the first time I really started questioning the script that life expects from us. Why were we both working? We don’t need more money…we needed more time together and with our kids. Shortly after child number two we decided enough is enough and Mrs. Happy Philosopher put down the stethoscope and accepted the much more challenging job of stay-at-home mom! The irony of this will soon become apparent.

This was actually a big improvement in lifestyle for us, and we went on with our lives taking things a day at a time. The economics of a dual income household and the psychological and social complexities of going from physician to stay-at-home mom are multiple blogposts (and probably books) which are in my brain waiting to be written, but I’ll save that for another day.*

I already knew I wasn’t going to be the kind of doc still working when I was 70, but I also never saw what was coming next – the strong desire to get out of medicine before I was 40. Life is all about cycles, ups and downs, so I thought the fatigue, cynicism and anxiety would be short lived, but slowly over time any joy I got from my career was slowly being drained. The speed and stress of the job remained, but now there was something new – tedium and boredom. The excitement of finding the abnormality and making the diagnosis was not as cool the 10,000th time as it was the first or even 1000th. I also started noticing a few things. I no longer got excited about the big doctor paychecks, and actually when I really thought about it I never really did. They were kind of cool at first, but the expensive shit that I bought didn’t bring me any more happiness than the cheap stuff I was replacing; at least not enough to justify the cost. In fact, sometimes it was just a reminder of the waste and extreme luxury that seemed so unnecessary. They were a reminder of my prison. It was a very comfortable prison, but I was still not free to leave.

I noticed a few friends and acquaintances dying in their late 30’s and 40’s. Cancer, heart attacks, multiple sclerosis and other rare neurodegenerative diseases. I started questioning why I was spending my life doing this. If I died tomorrow would any of it have even mattered? Why was I happier in medical school with next to nothing than now with almost everything?

Midlife crisis? Burnout?

Maybe both, but I was not happy and this path I was on was not sustainable. Becoming a physician is like boarding a train without knowing where it is going. There are decisions to be made like what specialty, private practice or academics, but all the tracks more or less seem to lead to the same place for most of us. Fifteen years later you forget you are even on a train. My burnout reminded me of this, and I was far from where I started. I had never really questioned where I was going, and, looking around, the tracks seemed to go on endlessly in both directions. Worse yet, it seemed there were no places where the tracks diverged or branched, nowhere to actually make a choice. I could just keep on riding, but my gut told me this was not the right decision. I would have to jump off and hope for a soft landing.

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Soft enough

Part 3: Planning my escape

I knew I would have the ability to retire early, I just didn’t know when, and to be honest I was a little ignorant about retirement planning. One guy I met who was married to a physician said that you need 10 million dollars minimum to retire. That’s a lot of money. He said this with a straight face by the way, no irony or wry smile behind the declaration. I was pretty sure I would be dead before I hit 10 million. I kept asking around. Most people had no clue and couldn’t put a number on it, but all agreed it could not be done before age 50. Shit. I was not going to make it to 50 on my current path; that much I knew. I needed to do some serious research.

I typed ‘early retirement’ into search engines and got nothing but poorly designed retirement calculators from big brokerages. I tried ‘extremely early retirement’ and stumbled down a rabbit hole I never found my way out of.

As I educated myself about how to retire early I discovered a small but growing subversive subculture of financial freedom and early retirement junkies. These people were pretty radical by conventional standards.  In this space apparently retiring at 50 is not even something you can write a blog about because it is so ordinary; 30, 35 maybe 40 is early enough to be interesting. I ran the numbers and knew I really didn’t have to work much longer, but I still couldn’t wrap my head around the concept. I mean do people actually do this?

I had my doubts. Maybe I’ll just plow ahead and see if things get better, I thought to myself. Well they didn’t; if anything, things got worse. One night I hit my breaking point after a particularly bad week and made the decision I would work 5 more years and quit. I told Mrs. Happy Philosopher and was very happy when she didn’t faint or divorce me. We agreed on the plan.

The problem with this plan however, was that I still had 5 years left and I needed to figure out how to make those 5 years manageable. All I did was get my sentence reduced from 20 years to 5 years. This didn’t make my cell any more comfortable. It is at this point I started down the path of self-discovery and experimenting with various aspects of my life.

 

Part 4: Awakening

We have been programmed from a very young age to add things to our lives to make them better. If we are depressed we buy shoes or power tools; if we are out of shape we get a gym membership or treadmill; if we are overweight we add a diet or weight loss supplements. We add alcohol, drugs, relationships, and season tickets to fill whatever void we have. We schedule more activities to fight boredom; we push our kids into more activities so they can be ‘well-rounded’. We take medications for diseases that didn’t exist until a pharmaceutical company noticed a side effect of one of the drugs they were developing for something else. There is a product for everything and an advertiser who is paid big bucks to sell it to you.

But we are never taught to subtract. What if I just took away all the things that sucked about modern life and left the good stuff? How did I even know which stuff WAS the good stuff? My first step was to go on a news fast and kill my television. I started learning to say no and eliminated many things from my diet to see how it made me feel. I experimented with alcohol abstinence. I started worrying less about the things I could not control (most things in my life actually). As I knew I would be working for years longer I needed to open up space in my life and started ruthlessly decluttering both physical and mental clutter. These things took me many years to accomplish and to be honest I still suck at most of them, although I’m getting better.

I was in a weird place for a while after my decision though. I didn’t know how I would handle the transition. I mean 5 years is an eternity when you are looking forward to something, but at the same time I knew it would be here in a flash. Time is funny that way. I didn’t know if I could just walk away at such a young age and go from 100 miles per hour to a complete stop. Could my fragile male ego handle it? More importantly would I drive my wife clinically insane forcing her to interact with me for so many hours a week? I had a lot of questions, and unfortunately no good answers.

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Wait, what?

Part 5: The light bulb

As the gears kept turning I convinced myself that an abrupt stop was not a good thing, but what if I could stretch it out over a longer time period? That’s it! I would engineer a part time position and just work longer. In my mind this solved many problems.   I could enjoy more time right now, work a longer career, battle my burnout and have an opportunity to go back to full time if things didn’t work out as planned. You see, there is something about being a physician (and other highly specialized careers) that many people do not understand, and that is if you are out of practice too long it is really impossible to go back to it, and there are very few things you can do to make this kind of money with the unique skill set developed over these many years of training. Simply put I was scared to give up this income stream so early in life. If a medical disaster or some other catastrophic financial thing happened I was scared of not being able to make this kind of money again. Admitting and embracing this fear was an important step for me. It helped me design the current part-time position I still practice today. I won’t bore you with the details of that right now as I will write a whole meta post on part-time work at some point.

 

Part 6: Resolution

This post is already too long so I will wrap things up. It took me several years to cut back from full time to part time for a variety of reasons, but something strange happened along the way. I changed my mindset and accepted either outcome. I realized I could be happy with either scenario. At one point it didn’t look like the job share was going to happen, but I was happier now regardless. Nothing changed with my job, but everything changed with my life. All those little experiments, having more mindfulness and gratitude, all the little changes added up to a way better version of myself; or at least a happier version. I would work a few years full time and quit or go part time and work later into my career. It ceased to really matter to me so much. I freed myself while still in the prison. Being so financially disciplined and frugal gave me incredible options that most people do not have, and that’s where this blog comes from. Going through this painful but awesome journey has given me an unusual perspective. Not unique because many have gone down a similar path, but different enough that I felt the need to share it. Happiness through freedom and freedom through happiness. These two concepts are so intertwined and connected, but at the same time so hard to get your arms around.

So there it is.

Welcome to the blog, and welcome to the real world.


*Unless I can somehow sweet talk Mrs. Happy Philosopher into writing about it.

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  1. DocT1

    Your path is remarkably similar to mine and to several people I know. Thanks for the blog. How many years post-fellowship are you?

    1. TheHappyPhilosopher

      I think there are a lot of docs that have a similar experience to mine, but I couldn’t find anyone writing about it. I’m glad it resonated with you. I’m a little over a decade out from my training.

  2. PhysicianOnFIRE

    So many physicians can relate to Part 1 and Part 2.

    Where to go from there is where there are many divergent paths. Some end in very bad places, some lead to continued pain, some are paths of enlightenment. It appears you chose the best path. Congrats!

    I had no idea your wife was an early retired physician. We need to hear more from her! Or at least about her.

    Cheers!
    -PoF

    1. TheHappyPhilosopher

      I would love it she wrote some stuff for the blog, but she is having too much fun staying busy with other things right now. Maybe someday I can talk her into it.

      She has some really interesting perspectives and could write about some things I just can’t do justice: some of the gender issues, truly walking away from her career so early when our level of financial freedom was much lower, how being a mom and a physician is different from being a dad and physician, etc.

      She is also much smarter than me, and can write sentences that are grammatically correct on the first try!

      1. Physician on FIRE

        Those all sound like great topics, and I’m sure she’s got a lot to offer. That being said, her energy is probably best directed to the family and other pursuits that she truly enjoys.

        If she loved to write, I believe we would have heard from her by now. Best to love what you do, and do what you love.

  3. Dr wise money

    Thank you so much for sharing your journey.

    I really appreciate your openness!

    1. TheHappyPhilosopher

      You’re welcome, thanks for taking the time to read 🙂

  4. Curt Morrison, MD, FACC, CFA

    I burned out and left medicine with no plan. Just had to make a change.

    I went to the bookstore and taught myself accounting and finance so that I could become a better investor. This led to a job as a healthcare equity analyst.

    Thirteen years after leaving medicine, I returned. I studied for more than a year, completed more than 800 hours of CME, scored in the top decile on board recertification, obtained licenses in two states, and found an excellent position (in a community where I worked years earlier).

    Working part-time is a better idea, but it is possible to leave and then return.

    I enjoy your blog very much. I’ve been reading many personal finance, FIRE, and physician-centric blogs recently, and this one is my favorite.

    1. TheHappyPhilosopher

      Thank you Curt, appreciate you sharing your story. Entering medicine is tough after a long hiatus, but certainly not impossible as you have demonstrated. I know several people who have moved from medicine into financial services.

  5. Dennis @ NestEggRx

    Your story mirrors mine in many ways. I know a lot of that pain and angst that comes with medicine today. What helped me tremendously was developing passive streams of income outside of medicine.

    Thanks for sharing!

  6. DadsDollarsandDebts

    I fight with these issues daily. My wife and I are not big spenders but continue to fall into certain traps (most recently an expensive home). My goal was to retire in 10 years, but with my new job and the prospects of a pension at 60, I hope to cut down to 60% by age 45. I think a good start for me will be to go to 80% in 3 years (after I make partner) and riding it out at 80% for a while. Either way it is deeply on my mind and helps direct most of my decisions. Kudos to you for pursuing this and it is important for our community to help motivate each other as we may be just 5% of the MD/DO population.

  7. BetweenTwoElephants

    I appreciate that you are writing about this subject. As the demands of physicians increase in the non clinical red tape that bureaucrats seem hell bent on increasing just to protect there own jobs burnout will become more and more relevant. We are really caught in a catch 22 where our medical decision making power is being stripped away but then we are expected to assume more and more responsibilty and liability for the sickest patients. Plus the entitlement of patients seems to rise every year.
    I am thankful that I still really enjoy taking care of people but the other aspects of medicine are getting more and more unbearable. Talking about it and being intentional in how we interact with each other and supportive will go a long way. I’m looking forward to following your blog.

    1. TheHappyPhilosopher

      Thank you for the kind words!

  8. FIREplanter

    Hi Happy Philosopher!

    Thanks for sharing your journey. We medics from old Blighty have so much to learn from our counterparts in the US on freedom fiscally and mentally. I am still early in my journey of self-discovery and feel my journey is very similar to yours.

    Word of gold I enjoyed:

    ”Our reality becomes defined and constrained by our knowledge and experiences, for better or for worse.”

    –We are after all humans and are limited by our 5 senses and our mind. I particular like this quote by Alan Watts, “Through our eyes, the universe is perceiving itself. Through our ears, the universe is listening to its harmonies. We are the witnesses through which the universe becomes conscious of its glory, of its magnificence.” We are the universe and the universe comes to being with our senses.

    “I started questioning why I was spending my life doing this. If I died tomorrow would any of it have even mattered? Why was I happier in medical school with next to nothing than now with almost everything?”

    –Fallible Man. We need to appreciate what we love more than anything. People, colours, sweetness, beauty, because when we are gone we can take nothing with us.

    “Becoming a physician is like boarding a train without knowing where it is going.”

    –This is an ongoing struggle for me. I am no academic but I enjoy the hustle and bustle of Cardio which is becoming more demanding in terms of research/publications/oncalls. Still deliberating on what path i shall take. Would appreciate more on how medics in US make such decisions and how they turned out and reassurance that ‘well it is never the end of the world’ even if you make a wrong decision hopefully.

    “What if I just took away all the things that sucked about modern life and left the good stuff? How did I even know which stuff WAS the good stuff?”
    –We never do until we eliminate it and find out that ‘hey actually, this wasn’t so bad after all!!’

    “I freed myself while still in the prison.”
    –That’s what I expect having Financial Freedom would give me, even whilst I may be working. The notion that your lifestyle does not depend on your income from your work gives you immense freedom. Even just the awareness of it can make a big big difference I can imagine. From your words, I can tell that this is possible true.

    Lastly, it is good that I come across your writings. I like the philosophy of this as much as the personal finance bit, and feel that perhaps it is even more important. People tell me I think too much. I think they think too little, or perhaps we communicate too little of what we think internally with each other. Nice to see things going well for you and give me some inkling of hope of what is possible.

    -FIREplanter

    1. TheHappyPhilosopher

      Thanks for the thoughtful comments FIREplanter. In sharing my journey my hope is that others will be able to more honestly reflect on their own personal situation. Like you, I probably think too much, but it is who I am and it makes me happy 🙂

      With regards to the train metaphor, I’m not sure there is another way. Medicine is just like this. The real enlightenment is figuring out you are actually on a train and deciding when to jump off and create your own path!

      http://thehappyphilosopher.com/how-to-live-a-life-of-quiet-desperation/

  9. Niyaz

    Hi.. Im an intensivist working in India and just discovered your blog. A lot of it resonates with me. I’ve been experimenting with mindfulness, frugal living, decluttering, not reading the news for about a year and thought of myself as a weirdo. Thanks for reassuring me that that is not the case.
    You write beautifully, yet simply.
    Hope to read more from you. And to keep in touch
    Thanks

    1. TheHappyPhilosopher

      What is weirdness to one is enlightenment to another.

      Thanks for reading.

      🙂

  10. Jason

    Was that first photo taken on the black sand beach at Waipio on the Big Island? If so, I’ve been to that spot and it is incredible!

    1. TheHappyPhilosopher

      Yeah, it is an amazingly beautiful spot. Tough hike down if I remember right!

  11. b

    Wow. Great post and blog. just found it. 44 y/o hem/onc doc strugglng with the exact same things. Thank you so much for sharing

    1. TheHappyPhilosopher

      Thank you b. I think there are a lot of docs that struggle with these issues. One of my missions with the blog is to give people permission to feel something other than what they are ‘supposed to’ regarding their career. 🙂

  12. DMoney

    Hi, HappyPhilospher – found you after listening to your great FIentist podcast. How timely, for me. I’ve just finished a week of leave after hitting a wall in my clinical practice. Very burnt out. Lacking compassion for my patients, distracted, sad, feeling trapped, etc. And let me tell you, one week of vacation got me back to at least functional, but not 100% productive or happy.

    Mid-30s, only 3 years out of training in a subspecialty which I used to love. Now counting the days (literally) left in my prison sentence (military commitment). Horrible commute, small kids at home, full-time+ employed spouse in high powered career, ever rising patient load and poor support from colleagues at work have all contributed to me getting to this point of burn out.

    Really looking forward to working through your blog to find practical applications for helping me get through the next 10 years. (10 YEARS.) Lord, help me…

    Thanks for what you’re doing

    1. TheHappyPhilosopher

      Thanks for the comment DMoney. Hang in there. As you have learned a week of vacation, or two or three will not rescue someone from burnout and dissatisfaction. When you are counting days something needs to change. Mid 30’s was when it hit me.

      Dig into the blog at your own pace. You will find some things that will probably help. Start making those tiny changes. Also check out this recent article I read. I think you may enjoy it.

      http://wealthydoc.com/blog/how-high-is-your-professional-satisfaction-could-it-be-higher

  13. JC

    Thanks for sharing HappyPhilosopher. I enjoyed reading your blog. Just 2 years out of training. I cut down on TV long time ago (ironically to study for the boards). I love my specialty but could use some more time off. You hear talking about work-life balance all the time but few people actually stop and think if they have it on their lives. The way our model is structured, -the more you work, the more you get paid in medicine-, obviously does not help. Posts such as yours help to keep things in perspective.

    1. TheHappyPhilosopher

      Thanks JC, glad you enjoyed it.

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