Permission to Burn the Manual

I started planning my escape in late 2020. I would find a way to quit healthcare, to cease being a practicing physician all together. Living the life of a doctor-mom, I felt consumed with daily obligations and duties. 

Guilt plagued me for feeling burdened by this life, for feeling it was a monotonous prison.   The guilt soon transformed to anger.  I was not showing up to my life in a meaningful way.  I held many limiting beliefs which blocked me from change.  How did I get here? A child’s dream of becoming a doctor sustained me into adulthood.  The dream was an all-encompassing mass-like occupancy in my brain with space for few other dreams.  Upon becoming an attending my dream was realized, but I found myself with a huge void where this space-occupying lesion once lived.  Now what?  In the absence of childlike wonder, it did not occur to me to create new dreams.   

In pursuit of my childhood dream, I faithfully lived by a manual - the book by which I defined my personal expectations.  Here I defined how I had to function to achieve this one dream and how I could secure approval, acceptance, love, and connection.  The manual’s overriding purpose was me becoming a physician.   

I was offered a new manual in residency consisting of the program’s expectations and daily schedule. These patterns became ingrained in my routine life, so I modified the manual by which I lived to incorporate these new tenets; they translated into my manual of “home” as well.   

As an attending, the new manual I had generated during training persisted.  Wake-up, go to work and devote most of my waking hours to work. Look for patterns and serve the patients.  Go home and serve as a wife and mother with any remaining time.  Sleep. Rise and repeat. The pattern was alive and well.  For many years I did not realize that living by this manual was optional.  How and why?! 

Watching an interview with Dr. Jill Bolte Taylor, I discovered my answer; day one of residency was the precise moment I said goodbye to whatever balance existed in my right and left hemisphere and said hello to a left hemisphere that would become more dominant by the day.  Daily my left hemisphere looked for the patterns that allowed me to formulate a differential diagnosis, calculated the risks vs benefits of treatment decisions, and generally focused on the facts.  Following a required pattern ensured maximum efficiency and learning — round on patients and then round with the attending. Attend conferences for two hours before finally finishing up patient care to go home.  I had no control over this pattern; my job was to comply!  My left brain had become my Arnold Schwarzenegger — my Terminator who determined what contributed to accomplishing and maintaining my childhood dream. 

In desperation caused by career burnout and with interventions from life coaching, my left brain, the saboteur, became more muzzled.  I began pondering bigger pictures, and gradually the chatter about finances, skillsets, and limiting beliefs was muted. Ultimately, I realized the world could be and was my oyster.  I was the one holding me back. Not the pandemic! Not my job! Not any circumstances outside of myself.  

Jill Bolte Taylor described her stroke as “a wonderful gift…in permitting [her] to pick and choose who and how [she] wanted to be in the world.” Neural plasticity is within all of us, and a stroke is not required to access it.  She describes enlightenment as the process of unlearning.  I too am “choosing to nurture those circuits that I want to grow and consciously prune back those circuits I prefer to live without.”  

It’s time for us to just go and be the person we want to be in the most expansive sense both inside and outside of healthcare. If you need permission, I hereby give it. Awaken your right brain, this tool we’ve forgotten to use. Then burn your manual.  If your manual defines your own expectations for self and thereby determines your own approval of self, I would argue your manual is not serving you. 

In the words of Mahatma Gandhi  “Each one has to find his peace from within.  And [for] peace to be real [it] must be unaffected by outside.”   

Our potential for peace and contentment is the same every day irrespective of circumstances.   With life there is endless potential.