I received an e-mail from a physician client recently, and its poignant message had me pause and reflect back on a difficult part of my journey from practicing physician to non-clinical business owner. She wrote the following, with fierce passion (and with her permission and my minor editing):

"I am grieving because I have finally made the full decision to leave medicine. Ischemic limbs, metastatic cancer, coronary artery disease--these are what I do on a daily basis and have done for more than 30 years. This is who I am. This is my purpose for being. This is my calling and my soul. In "Wild Minds: Living the Writer's Life" , Natalie Goldberg talks about writing in this way. For me medicine is elemental.  "Once you have tasted its essential life, you cannot turn from it without some deep denial and depression."  She was talking about writing. I am talking about medicine. For me, it is the same......... This may take a while to grieve, but I will get over it as I have every other loss in my life. And it may finally make me free. Did it not hurt you to give up medicine or was it not such an integral part of your soul as it is of mine?"

Yes, dearest client, it DID hurt me to give up medicine 10 years ago - but it was the medicine that I once knew and fantasized about. I missed the intimacy of my relationships with patients. I missed the special thrill that comes from delivering a baby or caring for three generations of a family or seeing a patient recover from a hospitalization. I missed gabbing on the phone with a pleasant specialist about a referral.

But I did NOT miss the bleak lunches with grumbling doctors in the hospital doctor's dining room, the indignation of patients armed with sheets of Internet downloads who weren't being given the medications they deemed necessary, or the panicked JCAHO-haunted medical records' staff messages telling me I hadn't signed my verbal orders that same day.

It took a seven-month intense "soul-search" to give myself permission to step away from my identity as a clinician and to expand my physician wings.

Even though I no longer want to be called Dr. Kennealy (just Philippa is fine), I am STILL a physician at heart - I still want to make things better - I still love to hear the jubilation in a client's voice when he or she sets and accomplishes a goal - I still want to address dis-ease, only this time it's the lack of ease so many physicians feel about their professional goals and new dreams.

And I want to become more - an accomplished woman, a loving spouse and parent, a friend or relative to be counted on, a creator, a fulfilled soul, and a responsible citizen. I believe I can stretch to accommodate all these elements of my being, AND continue to cherish the roles I have already played.  

I'd love to know your feelings about being a physician. Especially if you are considering a change in professional direction!