FOMO, Cancer, and the Practice of Medicine

 
Today, I’m honored to publish a guest post from an anesthesiologist who has an amazing story to share.

She reached out to me in the fall of 2018 to say a few kind words as a reader. We had some things in common. She had lived frugally relative to many of her colleagues. She was now working in a part-time capacity.

Her path to this point, however, is very different from mine. I simply realized I no longer needed to work for money and started working less.

She, on the other hand, had a very serious medical diagnosis that had her re-examine her entire career and its place in her life.

I thank her for opening up to share how she arrived at this place, and I trust you will find her story as inspiring as I did. You can find more essays from her at By Well Design.

 

FOMO, Cancer, and the Practice of Medicine

 

I have always valued my free time over work. I assume this is because I have the good fortune of living a life filled with great friends, family and interests.

Not to say that I didn’t value my work. I spent countless years working very hard, sacrificing the free time I held so valuable, to become a physician. As an anesthesiologist, I draw deep satisfaction from helping people in times of illness. Being there for patients when they are stricken with fear and pain is an honor and I am truly grateful that I am able to do what I do.

But nothing compared to the happiness and sense of purpose I felt when I was with my friends, my family, and most importantly, my son. After a long and winding road of sacrifice, burnout, financial planning and ultimately illness, I was able to advocate for myself and became a part-time physician. I am now able to work and enjoy my personal life in ways that are more fulfilling than I ever imagined.

 

FOMO Sets In

 

I graduated from medical school in 2001, shortly before the implementation of “restricted” training hours for residents. I can honestly say I know what it is like to go into the hospital at 6 in the morning and not leave until 11 the next night.

And even after the duty hour restrictions, which our residency director referred to as “guidelines” that were intended to be “averaged” over a month, I continued to work a brutal schedule for 3 more years.

At last, in the summer of 2005, I became an attending and found that, much to my disappointment, my schedule did not improve much. It was hard those first years to watch as others traveled, enjoyed holidays and time together with friends and loved ones as I covered hour after hour in the hospital.

The acronym FOMO couldn’t describe my state any better. Most of you know (and are probably tired of hearing) the meaning of this overused slang but just to refresh, the most recent definition from urban dictionary states:

 

FOMO:| fōmō |
-noun
a state of mental or emotional strain caused by the fear of missing out.
Evolutionary biology – an omnipresent anxiety brought on by our cognitive ability to recognize potential opportunities.

 

A few years after becoming a partner in my group, I married, and a couple of years after that I had a baby boy. I immediately found the balancing act of motherhood and working full time in a stressful field like anesthesiology overwhelming.

I worked long hours, sometimes 24 hours at a time. And when I was home, I did everything I could to be present for my son. As a result, there was little time for myself which just made me feel exhausted and emotionally drained.

I joked about the “nanny and me” classes I never went to and my son’s park life I knew nothing about to hide the guilt of my absence. I did not know his teachers or have relationships with other parents from his classes.

All the stress made me irritable and impatient which made it harder to relate to my partner and my son and I felt like a bad mom, always. When I look back at those times, it is not just the fatigue and exhaustion I remember, it was that deep sense and fear that I was missing out on my son’s life and as a result, I was missing out on my own.

 

FOMO_boy

 

A Cancer Diagnosis Changes Everything

 

And in the midst of this fog that was my life, I was diagnosed with invasive breast cancer. I was told that I would need two stages of surgery and chemotherapy and, in an instant, my role as physician changed to the role of a patient.

I stopped working and my treatments kept me out of work for nearly one year. It was during this memorable year that, despite the fear and pain of cancer, I became more relaxed and the fog of my life lifted. Nothing like a little brush with your mortality to reassess your priorities!

At the root of everything, without trying to sound dramatic, was a new Fear Of Missing Out on my son’s life, now in the worst absolute sense. I knew that I needed to make major changes and I intuitively felt both my happiness and health depended on it.

When it was nearing the time to assimilate back into my work life, I developed an intense anxiety about coming back and asking for what I truly wanted. I had a lot of guilt about leaving my colleagues, many whom I considered friends, to fill my shifts during those months I was away.

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I had a sense of embarrassment and felt weak and wounded. I looked different on the outside, but I was even more changed on the inside and had my doubts that I could ask for something so big.

But every time I faltered, I imagined how I would feel if my cancer recurred. I thought about the regret I would have if I hadn’t seized every opportunity to be with my son. It was this thought that gave me the strength to go to my chief and ask for what I wanted.

To go from working 50 or sometimes 60 hours a week to working 3 days a week, no call, and no weekends. I will forever be grateful to my chiefs, medical directors and colleagues who have been supportive of this decision.

However, none of this would have been possible without some critical financial decisions I had unconsciously made early in my career. I had inadvertently put myself on a path toward financial independence immediately after residency by doing several things right, and this enabled me to weather the storm during my illness as I watched my paycheck get cut in half overnight.

Because of these choices, not only was I able to be comfortable during my time off work, but I was able to pursue a part-time position when I returned.

I am the first to admit that I have made many regrettable mistakes with money (and have been the victim of what I consider bad timing), but here are a few things I could share in hopes to help someone get on the right foot out of residency. Nothing new is mentioned here but perhaps by sharing my story, it will be of benefit to someone.

 

FOMO_rainbow

 

Preparing for the Unknown (and Financial Independence)

 

Debt and Housing

 

When I graduated from residency, I bragged that I had eighty something dollars in my checking account and quite a bit of credit card debt. I immediately paid off all credit card debt within the first few months.

The one thing I believe has had a big impact on where I am financially today, almost 15 years later, was remaining in my cheap one-bedroom apartment for over 3 years as an attending.

With such a small housing expense, I was able to put away most of my first few years of income into stocks. When I painfully watched my balances drop by 30% in 2008, I shifted focus and began to save for a down payment on a house.

We chose a modest (but adorable) 1600 sq. ft 3-bedroom 2 bath home in Los Angeles. I told myself that we would live there until the stock market corrected and then sell and upgrade within 5 years.

But when life took a different turn, we were grateful for the small mortgage. It also made it very easy to choose to stay put in our current home over working fulltime. We love our home and it is more than enough space for 3 people. We also feel good about the reduced environmental impact we are making by keeping our footprint smaller.

 

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Adequate Benefits Package

 

Another component is how serendipitous it was to end up working for a company with excellent benefits. Early on in my career, I was able to cancel my expensive private disability policy that I acquired during residency (that only offered a small benefit) because I had a more robust and less expensive plan though work.

I was given ample time off and, most importantly, I am still eligible for full medical benefits as a part-time partner in my organization. I can still plan on vacation, education leave, bonus and even pension benefits (although all of them reduced due to my decreased work schedule).

 

Spending and Expenses

 

The last piece of the puzzle is how I changed my relationship with money and spending. I think about the wasteful way I spent and consumed those first five or so years of working with an attending’s salary and I have a lot of regret there.

Cars, clothes, handbags, outrageous vacations, etc… I can tell you that, for me, not a single object I purchased during those years brings me even a tiny fraction of the happiness I feel when I am working in my son’s classroom or practicing yoga on a Thursday morning.

We used to eat most meals out and paid for expensive fulltime child care. By curtailing my spending on frivolous items and cutting back on child care expenses, I am able to continue to work less, save, and still have plenty to spend on experiences, like traveling, that have more value to me now.

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So now I describe myself as a part-time physician and part-time stay-at-home Mom. I love being able to wear (and at times put away) both hats. I am known to quip to anyone who will listen, “I make half as much but I am twice as happy”!

When I am at work, I have noticed how much deeper I connect with my patients, having walked the path that they are walking. I often find myself listening, drying tears, and advocating for them in ways sometimes even out of the operating room.

I think they must know, on some level, that I understand them in a way some of their other doctors don’t and I believe this is where my biggest impact as a physician lies now. Working part-time has completely changed my relationship with my career. I have gone from bitter resentment to appreciative contentment. I am able to give more because I am there less.

 

The Benefit of Time

 

Paramount to everything else I can expend more time and energy doing the things I enjoy and being with the people I love.

 

 

I cherish the free time to myself to read, to write, to hike, and to engage in a deep practice of yoga, which I consider medicine for my body and soul. I have lunch with my dear, fellow “underemployed” girlfriends and go to the market without having to fight for a parking spot during the week.

 

FOMO_arch

 

But most importantly, for 4 days a week, I am with my son and my husband. We play soccer in the yard, play vicious rounds of UNO and go to concerts and museums.

I helped every week in my son’s computer lab during his kinder year last year and this year I help correct homework. I know his teachers well and have playdates after school. I picked strawberries with his class and I am there at nearly every assembly or performance.

But when I am not, it is OK because both he and I know that I am there every night to tuck him into bed. He does not remember what it was like before I was sick, but I do. I am happy to report that I am in the best health I have ever been in my life and I have finally been cured of my bad case of FOMO.

 

[PoF: I’d like to thank the good doctor once again for sharing this tale with us. I am impressed by the smart financial decisions she and her family made, even if they didn’t know why at the time. 

She discovered her “why” when an overwhelming work schedule was coupled with a potentially fatal diagnosis. These unknowns are not what anyone wants to plan for, but the pursuit of financial independence gives us tools to better handle any obstacles that life can throw our way.

Learn more about today’s guest author at By Well Design.]

 


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What do you most fear missing out on? Has good money management put you in a position to better handle life’s stressors? Do you have questions for today’s guest author? Let us know in the comment box below!

31 comments

  • Goodness. I could read 1,000 posts like this.

    Once you understand the “Why” behind your financial decisions, it really does bring everything into perspective. I am sorry that you had to go through what you did in order to figure your “Why” out, but it is a powerful story that we can all share from none the less!

    Money is not the end all be all. It is a means to an end, and the end is “Time.” Time is the real commodity that we are pursuing. Not the mighty dollar bill.

    Thank you for being willing and open to share your story. I think many people will benefit from it!

    TPP

    • Thank you TPP for your kind words!

      I agree, Time, is the most important asset we have! I am very fortunate to be in a position to work less so that I can spend that extra time with my family. We see so many people in our field work themselves to the point of exhaustion, just to support a lifestyle. It seems so senseless.

      BWD

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  • Wow, thanks for sharing your story. Choosing a modest 1600sq ft home on a doctor’s salary when the average home in America is now 2600sq ft. Was wise indeed. Housing is obviously one of the big three expenses and one where people make their gravest errors. So glad to hear your wise money choices set you up for the priority of free time!

    • Thank you!

      I agree housing is a big pitfall for Drs just starting their careers. We have delayed gratification for so long and get excited by the big pay change when we become attendings. Young Drs often over extend themselves by buying too much house, too soon.

      BWD

  • Amazing job of turning a diagnosis and awful situation into something brilliantly positive.

    Your great financial choices early on, especially with regards to housing in an expensive city, certainly paid off later when you needed it most.

    Going part time is not feasible for a lot of people because of the paycheck to paycheck mentality. But I love your saying of half as much but twice as happy. It shows how little money and happiness are correlated.

    Congratulations on you beating cancer and best of luck in future

    • Thank you so much!

      I hate to admit that, if it wasn’t for my cancer diagnosis, I would not be living the life that I am now. I am much happier than I was before! I hope by sharing this lesson, others won’t have to learn it the hard way.

      BWD

  • Great story and I am glad you are doing well! 1600 sqft in LA sounds perfect! We are also in the process of home shopping and I tell my wife that this is our biggest unknown. Once the home is purchased or financial life will make more sense again.

    • Good luck on the house hunting! It can be a stressful experience. I remember people told us to “buy the most house” that we could afford and I am so glad we didn’t follow that advice! I would focus on the best house for your needs and, if children are a consideration, in a good school district. Private school tuition can be another mortgage!

      BWD

  • ol1970

    First off I should say I’m very glad you were able to beat your cancer, find a work life balance, and be there more often for your son. The one thing though that really stuck out for me reading this is the total lack of mention of the role of your husband, I was waiting for the part where you mentioned you divorced shortly after having your son. No mention of being a wife to your husband, spending time on that relationship, or being partners in the process. Sorry if this is just a part of the story you left out, or it’s a bad situation, but I would think your partner would be of paramount importance to your story. Again I don’t mean to be offensive and maybe there is a part 2 to your story you just didn’t share.

    • Thank you for your response. I am new to writing personal essays so I really value your input. Your comment is not offensive at all, and I appreciate you mentioning it and bringing it to my attention. I can tell you that my husband is my rock and we are very close. I would not have gotten through my ordeal without him. I had a lot of complicated feelings when I got my diagnosis. One of the more unexpected feelings is guilt. I felt very bad about how it impacted all of the people in my life, especially him, my son, and my parents too. I likened it to an earthquake (must be my so cal roots). The patient is simply the epicenter of the situation and there is a ripple effect that hurts the people around you. I am forever grateful that he is in my life. I want to add, for the purpose of this story, we were not married when I made most of the financial decisions I mention in this essay.

      • ol1970

        I’m glad to hear that! I completely understand how difficult it is to write about a situation like this and relay the whole story without it tuning into a novel. I think I am hyper sensitive to this because I’ve been in a situation before where I was priority #4 behind her family, her child, and work…nobody wants to be #4 : ) Having a great partner makes life a hell of a lot easier and worth living.

  • Very wise.
    It takes courage to do something a little different.

    Stories like this one and those highlighted by Crispy Doc’s series on doctors who cut back are helpful. It demonstrates what can be done.

    Without those examples we think our only choice is the standard one: let your medical career grind you down and destroy you.

    Thanks for being vulnerable and sharing.

  • Lynne

    What I don’t understand is the reasoning behind the brutal work hours. Is it because doctors are in such short supply, or some misguided thinking that immersion training is the best approach? Is the USA unique in this custom, or is it prevalent in other countries?

    All I could think of when reading about her arrival at work at 6am on Day 1 and departing work at 11pm on Day 2 was that such a brutal shift encourages mistakes.

    My early years working in IT occasionally required working through the night after a normal work day, and I can attest to the mental fog one experiences from fatigue and sleep deprivation. I can’t comprehend this being “normal” working hours. No wonder doctors burn out.

  • Psy-FI MD

    Your story is a constant reminder to us all of how short life is. Additionally, we don’t know how much time we actually have. We have to do the things important to us before we run out of time and live with regret.

    Thank you for sharing your story.

  • Thank you for sharing your story. I admire you for creating a life that you really want after recovering from your cancer diagnosis & treatment. Your self-awareness before, during and after your health challenges helped you to craft a balanced lifestyle that now brings you so much joy. Many people do not have the option of cutting back on their working hours, for whatever reason. I’m very happy to read about people who can and do cut back to create a balanced life that incorporates all of the elements that are more important to them. Your story is a reminder that no one knows what the future will bring, that more money doesn’t equate to more happiness, and that self-awareness is the key to knowing what kind of life we want to live.

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  • Great post! I totally relate how sometimes what you think is the worst thing that could happen to you, actually becomes a gut check and suddenly becomes the best thing that could have ever happened. Hopefully, most people won’t have something terrible happen before taking a deep look into their lives to make sure their priorities are aligned with how their life is being lived. I love that you appreciate your career more now that you are doing it less and enjoy it.

  • Mai

    This story resonated with me deeply. I’m one year behind you in the cancer journey and also went back to work part time after I completed Treatment. I had immense guilt for abandoning my team and patients (also a doc) but now I always remember that my son only has one mommy and patients will still be there regardless if I’m working or not. I love working part time! I was on the fast lane to burn out until I got cancer. I think it was the wake up call we needed for me to really step back and focus on what matters. I’m grateful for a high earning husband and our interests in personal finance have allowed me to work less without a major change in our retirement savings. Here’s to loving life more!

    • Dearest Mai,

      I am so sorry to hear you have to go through this too, I am sending you big hugs. But at the same time, happy to hear you have created a life you love! I LOVE working part time too! I wish it for everybody 🙂

      Feel free to reach out to me privately through my website if you ever need to chat

  • Beautiful story.

    >>deep practice of yoga, which I consider medicine for my body and soul

    I’ve heard many say that yoga is calming and/or can put you in a calm/restful state. I do not find that to be true for me, but I have found practicing yoga forces me to try to *maintain* a calm/restful state so I can do it. If my mind is racing or I have fires that need to be put out, I find it difficult to practice yoga. Thoughts?

    • Hi!

      I have a lot of thoughts on yoga! Lol. Obviously it is simply my opinion and I recognize it is not for everyone. It was a big part of my process for getting my strength back after my treatments and surgeries. I also felt it helped a lot for the anxiety that comes with a cancer diagnosis. There are a few studies out there that show some small measurable benefits for women fighting breast cancer. No miracle cures here, but appears to have benefits for quality of sleep and reported physical functioning. Anyone considering it should definitely check with their doctors before. I had to get “cleared” from my surgeon before I could do certain types of exercises.

      I think the mind racing thing happens to most of us! I find it is a little better if I have a teacher I like and I prefer the vinyasa practice which can be very physical. This keeps me focused more on my body and less on my thoughts. At the end of the day, I just try my best and not worry about it too much!

      I am assuming that you are a man (since your name starts with a Mr!) so thought I would also mention that my husband had found it beneficial too. He likes to play basketball but is not the best about stretching etc and so he gets very tight. He doesn’t go very often but when he does, he prefers the restorative type classes.

  • Beautiful story about confirming what really matters, and I love how it’s a little bit of a lot of things — part-time work, part-time SAHM, weekly yoga class, etc. I think these portfolio type lives (doing a little of this, a little of that) will become more common, and it’s about time. I had a consulting business which enabled me to flex my projects and my schedules so I could also flex parent my two daughters, still go on dates with my husband, and do my creative hobbies. Little bit of a lot is the best!

  • Thank you for sharing your story. I too had my life change when my wife had a positive breast biopsy. I had been putting off a cruise to Alaska that she wanted to do. I suddenly realized it was possible we could never do it. So I booked the cruise for after her treatment was finished. All is well today but we don’t put off those fun things on our bucket list anymore. Time is shorter than you think.
    I plan to add this to Fawcett’s Favorites this Monday.

    Dr. Cory S. Fawcett
    Prescription for Financial Success

    • Dear Cory

      I am so happy to hear that your wife is well and that the two of you were able to enjoy that cruise. It is such a common disease and affects so many. I think it can be a wake up call (as it was referred to by another commenter who suffered a similar experience too). Although I am sorry that the two of you had to endure what was a difficult ordeal, it is great to hear how you are now living your lives to to the fullest.

      Take care,
      BWD

  • Lil

    Thanks so much for sharing your story! I am so glad you are well and that you are relishing your life. Life is short, nothing is guaranteed.

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  • Arrgo

    Thank you for sharing your story. Having just gone through a unexpected health issue and surgery, it makes you take a step back and look at some things a little differently. After having automatically saved and invested over the years, I feel lucky that I’m not pressured to get back to work or worried about paying my bills right now. I am able to take it slow for a month or so to recover properly. All the appointments etc can really consume you both mentally and physically. Hard to even think about work when something like this is going on. Its good to be prepared as you just dont know when these things can happen. The moral is that like you, its good to have your finances in order ahead of time and have the discipline to do it even when you dont think you need to. Wishing you all the best.

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  • This is a fantastic post-well written and it was very generous of the author to share it with our community. Thank you!

  • Charlene Bagwell

    keep the positive attitude which helps to cure cancer. Cancer is complex and is also an evolving disease. The continuous treatment is needed. The treatment can be expensive, you can take the help of the health insurance plan from The Health Exchange Agency company which provides the plan with the best deals and discounts. My friend’s uncle is also enrolled there. They offer choices of the plan according to your need.

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