FOMO, Cancer, and the Practice of Medicine
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:
–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.
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.
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.
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.
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.
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.
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.]
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!