“I know you’re taking a break right now, but do you think you’ll ever go back to medicine?” Mal asked, after I recounted a story from residency that I remembered as hilarious but, in retrospect, was probably traumatic.
We’d lingered at the restaurant a little later than the other guests, leaving only when Emiliano loudly announced that he would be retiring for the night. It being a temperate Friday night, every twentysomething with a functional liver had spilled out onto the streets, which meant I had a twenty-minute wait for my Uber. Mal, ever the gentleman, offered to drop me off at home, but I declined, and he refused to leave ahead of me. I gave him back his sneakers, and we settled on the bench outside the restaurant, watching cars whiz by and listening to clubgoers in Y2K-chic argue about which bar would have the strongest drinks.
I winced, waiting for the judgment that invariably accompanied this question—the insinuation that I was wasting my degree, that I owed society a debt that I had yet to pay back, that it was deceitful to call myself a physician when I’d never practicedindependently—before remembering that Mal had offered his opinion on this before, and that it had been gracious.
“I think so,” I said slowly. “I just keep waking up every day hoping I’ll finally be ready to restart. I’ve got a few recruiters in my inbox right now. And one of my old attendings... he really wants me to come back and do additional training. But I haven’t been able to get myself to respond to any of them. I’m still exhausted, somehow.”
Mal nodded. His expression was perfectly neutral, neither critical nor supportive.
“Do you miss it?” he asked.
I pondered his question. “I miss a lot about it,” I confessed. “My primary care patients, especially. I had to transfer their care to an intern when I graduated. She still sends me updates sometimes. Things like, ‘Ms.X got her surgery! Mr.Y wanted me to tell you he quit smoking!’”
“You’re smiling,” Mal noted, smiling too. “Makes me think you actually enjoyed it.”
“Yes, well, I actuallylikemedicine,” I said.
Even the intensive care unit, like Dr.Makinen noted, had once called to me. The high of snatching a person from the jaws of death, using nothing but my understanding of their body and the skills in my hands, had been unmatched. Knowing that I wasn’t just useful, but pivotal,necessary, in the course of an entire family’s life.
But the rest of it? Acting as a stewardess for society’s ills? Hearing my colleagues who’d grown up with two doctor parents refer to poor patients as “not wanting to help themselves” when they showed up in our Emergency Rooms worse for wear? Spending my days off duking it out with insurance companies who refusedto cover vital prescriptions and procedures? The endless stream of paperwork and messages and phone calls from desperate patients whose questions I couldn’t answer and ailments I couldn’t cure, their need for help necessarily superseding my own for sleep? The rush of repressed memories that consumed me the second I got rest, the way the horrors I had witnessed always managed to reconstitute, months later, in my nightmares?
“So much of medicine isn’t taking care of people,” I continued. “It’s being pushed past all of your human limitations and still being expected to overfunction, to be empathetic and kind and make zero mistakes on two hours of sleep and a diet of ginger ale and peanut butter cups. It’s knowing that you can do everything within your power to help your patients, but that it’ll change nothing, because outside of the hospital no one gives a shit about them. It’s having to answer to people who care more about a bottom line or their own egos than they do people. And besides that, the money isn’t always as good as people think, especially in primary care—”
I clamped my mouth shut, suddenly ashamed to be caught mid-vent, more ashamed of what I was going to say next. It was all well and good to claim that I was just tired or burned-out or ethically conflicted. But that I was greedy?
Next to me, Mal’s silence was expectant. I realized that he was waiting for me to continue, that, unlike the many who’d inquired about my hiatus before, he was more invested in hearing my response than he was in crafting his own.
“Are you worried that I’ll judge you for talking about money?” Mal prompted after a moment.
“Most people would,” I said, stretching my legs out on the sidewalk in front of us, studying the way the headlights of passingcars reflected off my shins. “Doctors get paid well compared to the general population. No one wants to hear me complain about a six-figure salary, even if it comes at great expense. Really, I’m not supposed to care about the money at all. Being a physician is a calling, or whatever.”
“Is it?” Mal said. He shifted closer, his shoulder bumping into mine, and when I turned to him, his expression was gentle. “It doesn’t have to be. It can just be a job.”
I winced. “See, that’s why I’m confused,” I said quietly, “because calling it ajobdoesn’t feel right either.”
A crowd of college students ambled by us on the sidewalk. One of them stumbled, giggling, into her friend’s back, and they held on to each other, as if their four tangled legs could better keep them steady on their feet. Mal cleared his throat, his gaze following the students as they crossed the street.
“You know, I’ve always heard the saying that life is short. And I used to interpret that to mean that I had to figure myself out as fast as possible. That I didn’t have time to waste. That if I wasn’t careful, my clock would run out before I could make something of myself.” Someone drove by blasting Bad Bunny, and Mal waited for them to pass before continuing. “But now I think it means that I should try to live authentically. To be true to myself whenever possible, to be okay with the fact that what is true for me might change over time. And I think... to get there, I have to know myself, know what I want, know what I’m working toward.
“Like—here’s a question for you: When you imagine a world without limits, without bills, without duty and expectations, what do you see yourself doing?”
A breeze blew by, and I shivered, watching Mal’s face in profile, trying to learn it.
“You go first,” I said.
Mal turned to me fully, his features outlined in a soft yellow glow from the streetlamps.
“I would keep writing,” he said. “But I’d be more nomadic. Write a book in a villa in Bali, then the next on the coast of Spain. And... I’d pick up my camera again. Go to thrift stores and get stuff to create sets. Shoot more places, more people, just for the love of it.” He nudged me, gently, in my side. “Your turn.”
I stiffened. Even though I’d asked for a head start, I still wasn’t sure if I had an answer.
“I don’t know,” I confessed in a small voice after a few long seconds.
“Jo,” Mal said, stunned, “you have, like, three hundred thousand followers—”
“Four hundred and ten,” I corrected.
“Okay, four hundred and ten,” Mal clarified, rolling his eyes. “Four hundred and ten thousand followers. How do you get to that without an agenda?”
