The Physician Philosopher. Money Meets Medicine podcast. Associate Prof Anesthesia. Author Physician Philosopher’s Guide 2 Personal Finance #GoDEACS #medtwitter
Dec 7, 2023 • 5 tweets • 1 min read
When I finish medical school…
When I finish residency…
When I earn an attending physician paycheck…
When I buy the nice house or the nice car…
THAT is when I’ll be happy
This line of logic fall short in reality for most. It is called an Arrival Fallacy
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An arrival fallacy (coined by Tal Ben-Shahar) is the idea that..
Once we arrive. Once we to our goal. That’s is when we will experience longstanding happiness.
It is called an Arrival Fallacy for a reason
It isn’t true.
As Gertrude Stein said, “there is no ‘there’ there.”
Jul 2, 2023 • 4 tweets • 1 min read
I was an intern on peds the 1st time an Attending pulled me aside to give me feedback
And I’ll never forget it. It has served as an example for me ever since
After asking me how I felt I was doing, she said “Jimmy, let me give you some honest feedback”
A lesson for July:
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She continued, “Jimmy, you are easy to work with. This may seem like a good thing, but it could hold you back.”
“Your knowledge base could be improved. Because you are respectful and do your job, you may not be called out on that.”
“This is an area you can improve.”
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Jun 26, 2023 • 5 tweets • 2 min read
When I finished training we had a multi-six figure sum of student loan debt.
So, I picked up extra shifts to pay my student loans off faster.
The problem was that I thought “If I don’t pick up a shift I am losing money!”
I was trapped in a never-enough work mentality.
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And I’m not alone.
A chronic pain doc once said to me, “I haven’t taken a week of vacation in 5 years.”
He didn’t say it because he was proud. It was very matter of fact.
When he took vacay, he also didn’t make money.
So he just worked while his family took vacation.
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Jun 24, 2023 • 6 tweets • 2 min read
As I pulled my resident aside after a tough day doing regional anesthesia, I asked the same first question I always ask when I have clinical competency concerns,
“How are things at home?”
Most of the time the answer is “fine.”
This time the answer was “I have cancer.”
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It turns out this resident had a recent scare from a prior leukemia diagnosis.
They were going back and forth to the cancer center to make appointments when their busy schedule would allow.
It turns out that the clinical problems were stemming from a non-clinical stressor.
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Jun 13, 2023 • 7 tweets • 2 min read
I was at the beach. It was bedtime, and I was tucking my two kids in bed.
As I read The Lion, the Witch, & the Wardrobe to them, that’s when we heard sirens go by the beach house
A few minutes later, we heard the helicopter landing in the field behind our house. Strange.
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My 3 and 6 year olds were excited by helicopters. So we went to check it out.
When we went on the back porch, the helicopter was there in the field, but so was the ambulance we heard earlier
Someone was undergoing an air-evac behind our house
… but something was wrong.
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May 26, 2023 • 8 tweets • 3 min read
The stress was real.
I thought about moving. I thought about going part-time. I even thought about leaving medicine.
… but I believe in making a diagnosis before treating a problem.
What was the diagnosis? It turns out it was a lack of autonomy and feeling under valued
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As a husband & dad, having no control over missing the tee ball games, recitals, and school events started to get to me.
And my wife took the brunt of it. She deserved better.
I also didn’t have a ton of control over my assignments at work.
My autonomy was under attack.
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May 25, 2023 • 5 tweets • 2 min read
I was 3 years into being an attending physician when I found I was unhappy.
I told myself once I….
…Pay off my loans
…Buy a bigger house
…Get promoted
THAT is when I’ll be happy. Except I’d get there, and the happiness was fleeting.
This is called an Arrival Fallacy
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The Arrival Fallacy is when we focus on the horizon hoping that someday we will get “there” and be happy
… but Gertrude Stein had it right when she said “There is no ‘there’ there”
When we place our happiness in “Once I..” or “Someday..” an Arrival Fallacy is not far away
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May 23, 2023 • 6 tweets • 2 min read
When I was an intern I botched a central line on a septic patient with an INR > 4
As the large hematoma started to form my upper level - while putting on a gown - said,
“Well, you’ll never do THAT again.”
That’s when the self-judgement started to eat me alive…
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As an aspiring anesthesiologist in training, I ended up staying up all night, unable to sleep.
All because of one mistake.
The problem is that I made this one mistake mean that I was going to be a terrible anesthesiologist. It was a sign.
