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So, when I started The 46 Project I thought I’d have no problem writing something profound every three or four days.  Well, that was pretty naive.  Having a few days off between careers gave me a false sense of how simple all of this might be and just how easy it might be to help others as I helped myself.

Wrong, wrong, wrong.  Wrong.

Writing is cheap therapy, but has been a victim of the clock.   A few folks have checked in with me from time to time and wonder what the heck I’d initially been rambling about and how I’m doing.  The honest answer – I wasn’t happy.  I wasn’t healthy.  I was most definitely on a road to physical and emotional ruin — and something had to give.  I could keep trudging forward as a foot soldier in a broken system that didn’t really value my patient care outcomes or personal well-being — and die young myself,  or I could do something else.  Anything else!

Over the past couple of years, I’ve consumed far too much online content from others in an effort to organize my own thoughts, plans, goals and aspirations.  The result has been mostly noise.  Static.  The opposite of clarity.  A bunch of upbeat twenty- and thirty-somethings who’ve barely started their adult lives claiming to know the secrets of happiness and success.  And I can say with the benefit of age and experience, a lot of it is bad advice wrapped in a virtual world insulated from the people it hurts.

There is a flood of bloggers and YouTubers espousing to have the answers without really defining the questions.  And certainly without defining my questions and problems.  Compare that to the doctor gig – where bad advice can hurt your patient and even cause death.  Even good advice all too often has significant risk, and we are on the hook for whatever happens.  Such responsibility breeds maturity, but at a very real cost.  Insulation and disconnect just breeds more noise.

I started this post after watching a highly renowned marketing guru adamantly state that every single person should blog and post something every single day.  I sat down, inspired.  And then I thought–if everybody–posts something–every day–then no post is special.  It’s like a statement made recently by a colleague that if everything is emergent/stat, then absolutely nothing is emergent/stat.  It all just becomes homogenized noise.

So, what are my questions and problems?  Many are personal and will remain that way, but the most relevant problem today is the one that finally beat me down and out of practicing hospital medicine.  I saw one patient at a time.  Then the next.  Then the next.  Day after day after day after day.  Each patient already diseased and stuck in the hospital due to their disease(s).  I was working at a far end of the spectrum, where failure, misery and death was far more commonplace than any real degree of happiness, hope or joy.  I lived and worked at the part of the bell curve where no one wants to be.  I, myself, was drifting to that end of the bell curve, and I knew exactly how my own story would end without drastic change.

Going to work everyday and seeing patients suffering from diseases of affluence and overindulgence while others suffered from diseases of economic, emotional, and spiritual poverty was draining in a way from which I will never fully recover.  And that is a good thing.  The toll on my own soul was real and still weighs heavily on my heart.  But instead of focusing on the burden of yesterday, I am focusing on how it will motivate me today and tomorrow.

American healthcare can’t win the battle with one doctor, seeing one patient at a time.  We need to be creative and industrious.  We need to embrace new ideas and move past models that are little changed from the ’50s and ’60s.  So, I opted out of what is a failing system for a chance at success.  And in so doing, I’m doubling down on being a physician and helping myself while I explore new ways to reach out and help others….before they need my colleagues in the hospital.  Physicians are teachers, as well as life-long learners, and today I finally hear the school bell cutting through the noise.  Class is in session.