Song of Ascents

"Are you ready to leave clinical medicine?"

His indifferent tone belied the importance of the question, not just to me but to the eight other people currently sitting around the table, waiting for my response with varying degrees of patience and interest. Outside, an unseasonably warm January day coaxed buds from the trees dotting the hospital campus.

I looked over at the chief medical officer of the hospital and blew out a wry breath. A half truth slipped out before I could stop it. "Is anyone really ready to leave clinical medicine?"

He raised his eyebrows at me, unimpressed, and I gave myself a mental shake. Zoe, you planned this one, I chided myself. Follow the script. My interviewers didn't need to know everything - anything, really - about me. They just needed reassurance I wouldn't try to stick my nose into issues outside my job description.

Issues like patient care.

I glanced down at my hands, hoping they would take my short pause as merely evidence I was preparing a good response. Then I pasted a confident expression on my face.

"I won't sugarcoat that I love my patients and I love taking care of them. But I'm also excited to transition to what I view as a different way to care for patients..."

Blah, blah, blah. They seemed satisfied.

-----

Of course I'm not ready to leave clinical medicine. I'm less than five years out from my training and I only just reclaimed my love for patient care after having it stripped from me during residency. How am I meant to leave all that I have here? The team that I have lived life with, who saw me come into my own as an attending - who helped me navigate the new reality of my career-ending diagnosis? The patients who I laughed and cried (and argued) with? I'm not even a little bit ready to give up the intense controlled chaos that was my ER job. Even on the days I hated it, I loved it. 

But I can't suture anymore. I can't open a package of gauze, or reduce a difficult joint, or any number of things that require physical strength, manual dexterity, or both. And I'm worn out. In my ER, I was working twelve (read: thirteen or fourteen) hour days, constantly on my feet, often without a break. That used to be exhilarating; over the past couple of years it became simply exhausting. For every shift I worked, it would take anywhere from a couple of days to a week to recover my strength. 

So I spent the past year quietly, reluctantly looking for a desk job. I picked up a side gig reviewing medical claims for insurance companies and quickly realised that the only time I liked the work was when I could get coverage approved. It paid more in experience than dollars, but I can't be mad at that, because that experience is what got me to that hospital interview, pretending I wanted to be there.

-----

When they called a couple months later to offer me the job, I was at work in the ER, because of course I was. Actually, I was juggling two other phone calls and an ambulance was arriving when my cell phone rang. There was no chance I could actually pick up. In a moment of mild hysteria I thought, if they don't give me the job because I didn't answer on the first ring, so be it. 

Later, I finally called them back. 

"Are you so excited?!" Apparently they were very excited. I closed my eyes, shoved a swell of grief to the side, and chirped, "I am! Thrilled! Looking forward to it!"

-----

The title of my new position is physician advisor. My role will be somewhere between administrator and consultant, and it sounds like it will involve wearing several hats. I'll deal with insurance companies on behalf of the hospital, help with billing/ coding issues, and hopefully get to do a little education. Honestly, it's a good job, and one where I will be able to take some of the load off doctors while still directly impacting patients in some way. Once I give it a proper chance, I'm sure I'll like it.

I keep telling myself that, anyway. One day maybe I'll even be convinced. But I know it's not really about what I'm heading into; the problem is all that I'm leaving behind.

-----

In the Old Testament of the Bible, nestled in the middle of the psalms, is a series called the Songs of Ascent. They were songs for the ancient Israelites to sing as they made their pilgrimage up the mountains to the temple in Jerusalem. You would think a series meant for holy pilgrimage would be purely triumphant, but it is not. Instead, the songs are beautifully complex. They speak of fear and hardship, and then comfort with reminders of God's love. Sometimes they grieve. Sometimes they ask for mercy. Make no mistake, God's people suffered. They suffered, and they grieved, and they trusted God, and they worshipped Him. And ultimately, the songs rejoice, sharing the wonderful things God has done for His people and trusting that He will continue to care for them.

These songs have become my close companion; it's comforting to know I'm not the first. Others have lost things and made it through, singing. It gives me hope. I have hope that there are more good things to come, and that God will give me continued meaningful work even though I won't be seeing patients anymore. I have hope that I will have a place again one day where I can have a team I love, where I can belong and contribute. I have hope, above all, that this is a journey that the Lord has blessed. So as I grieve and rejoice, as I remember the incredible things God has done in my life, as I fight my fear of the future,

I wait for the Lord, my whole being waits,
    and in his word I put my hope. 
I wait for the Lord
    more than watchmen wait for the morning,
    more than watchmen wait for the morning.