First Things First: Ask The Right Questions

Author: Lisa Chu, M.D.

"Start close in,
don't take the second step
or the third,
start with the first
thing
close in,
the step
you don't want to take."

David Whyte, "Start Close In"

So you know you want to leave medicine. What should you do? Who should you talk to? Where can you go for help?

Joe Kim has assembled and is building an amazing community right here online. These days, the internet is the quickest and most abundant way to make connections with people who have very specific interests, especially ones that aren't talked about in social settings or at work (like leaving medicine).

There is a huge amount of great information, advice, and resources to comb through. This is an amazing gift. Sift through it all, and see what catches your interest.

But before you slip into panic mode and think, "How am I going to pay off my student loans? How will I send my children to private preschool? How will I afford a Chinese AND a French nanny AND violin lessons? What about health care reform? What about the economy? What about EGYPT??", I invite you to take my mini quiz.

There's no Kaplan review course, there's no answer key, there's no standard deviations to judge your results on. This quiz is for your heart and your spirit, parts of you that may have been sleeping since you were three years old, but have always been alive, waiting for you to listen.



These questions may have never been asked of you by anyone before. Breathe. It's OK. You're in the privacy of your own home, or at Starbucks, or in the on-call room at the hospital. You will not have to show your answers to anyone else. Pretend you're looking up lab results for your patients, or taking a practice test for the Boards, or something else “productive” if it helps you relax. Then take a few more deep breaths, and ask yourself to complete the following statements:

• "If I didn't care what my friends, family or coworkers thought of me, I would __________________________________________________."
• "If I had all the money I ever needed, right now I would ________________________________________________.”
• "When I'm not trying to impress anyone, I like to ___________________________________________________."
• "If I didn't have to worry about meeting anyone else's expectations, I would ____________________________________________________________."
• "When I get very still and quiet and the only person I have to answer to is me, I feel that I was born to _______________________________________."

Think these are "soft"? Worried that if you actually "go there" and try to answer them, you'll become some kind of loser hippie artist who lives in a studio apartment or begs on the street corner in front of the Starbucks you're sitting at?

Notice it.

That's the well-practiced, well-trained, constantly reinforced part of your brain saying, "Be afraid. Be very, very afraid." It's the part of your brain that is always broadcasting one of three thoughts: "You're not good enough," "No one will ever love you," and "Something bad is about to happen. Something VERY bad."

If you begin to observe yourself and listen to your own thoughts, you might find that most of your decisions in life have been made in response to this voice. Or rather, in an attempt to avoid the danger (failure!) that this voice warns you about.

Maybe this scenario sounds familiar:

"You're not good enough," says this part of your brain.

"Oh yeah?," you say, "Well I'll show you! I can stay up all night studying, not pee for three days, and subsist on a diet of saltines, graham crackers, and juice boxes, all while maintaining a professional demeanor and absolute clinical objectivity! Ha! Not good enough!" You then proceed to collapse with flu-symptoms for the next three days, or, worse yet, show up at work and snap your coworkers or patients because you can't believe you're not good enough to withstand that kind of bodily torture. After all, you're a tough medical resident, right?

Or how about this?

"Something bad is about to happen. Something VERY bad," your brain says to you.

You've just frozen because the attending on rounds has asked for a piece of data that you did not happen to write down on the index card (oh yeah, you use PDAs now) you're using to present on rounds. He's also pimped you for the differential diagnosis, which you did not have the time to research last night in between the codes, admits, and blood draws. And sleep. You actually slept instead of looking up all the answers to the questions you’re being asked right now. In other words, you are lame.

"I'll never get into the residency I want to. I'll never get the early match for ophthalmology, and I'll end up having to do FAMILY MEDICINE or something! Gaaahhhh! How could I BE this bad??" Yup, that’s the same part of your brain talking.

Later that day, you buy three bags of Oreo cookies from the vending machine and scarf them down to make yourself feel a little less bad. Temporarily.

We've all been there. What I'm saying is that until we recognize the mindsets and thinking patterns that have gotten us to where we are, and until we develop an attitude of *acceptance* toward them (this is the important part), any decisions we make, and any changes we make in the external circumstances of our lives will produce the same results.

We might get a new job, but we'll still be constantly afraid of getting fired. We might make more money than we ever imagined possible, but we’ll still think there’s not enough. Or, if you’re like me in the case of my violin school, you may even create the business of your dreams, but overwork yourself into exhaustion, burning out on the very thing you created.

Part of you already knows that you need to change. If you're still reading this, then you're probably one of those people. Or you're just extremely bored and really don't want to get back to your job.

Questions To Start Asking
My approach to "career coaching" is really not about your career at all. I call myself a life coach who helps people to live more creatively and passionately. But "creativity" and "passion" are hardly topics to talk about in my very first blog post on this site, so let me summarize this way.

From going through several career changes myself, and now from working with and talking to many more people who have done it also, I know that real, lasting change, and real joy (which is what we're all after on some level, right?), come from asking the right questions first. Here are a few to start:

What are you believing? All suffering is an invitation to ask, "What am I believing right now?" It's called inquiry, and it's a process that is used in many spiritual traditions. I've found that behind every instance of suffering is a belief in a painful thought. For example, some painful thoughts I once believed were, “I’ll never find a job right out of medical school,” and “I’ll never make more money than I could have as a practicing physician,” and “I’ll never be able to live in California like I always dreamed.” All three were proven to be untrue, but I absolutely believed them at one time. When I first teach the inquiry technique to people and they begin to see that believing their thoughts is the source of their suffering, the first tendency is to want to blame themselves for everything that has ever "gone wrong" in their lives. "I'm a fool for making all these bad decisions! I'll never get it right!" After I take the butter knife out of their hands, I calmly remind them, “YOU are not the same as YOUR THOUGHTS.” Once you can create enough distance to observe a thought, you can imagine that thoughts merely pass through your mind, and that you can consciously choose to grasp onto them, believe them, or simply let them go.

Is it true? Start questioning the thoughts that cause suffering. When you find a painful belief, ask, “Is it true?” Then, “Can you be absolutely, one hundred percent, sure it’s true?” And then, “How do I react when I believe the thought?” And then, “Who would I be without the thought?” For more on this simple, yet powerful, form of inquiry, visit Byron Katie’s thework.com. For specific examples of this inquiry in medicine, visit my website…

How do you treat yourself? Do you know what it feels like to FEEL GOOD? Do you allow yourself to feel good? Maybe you have the belief, “I’m not supposed to feel good.” Question that thought. Many doctors or former doctors I talk to are far removed from the moment-to-moment bodily sensations that are constantly sending signals and guidance throughout the day. Many have turned to external "proxies" for the good feelings that the body can naturally produce, substituting or numbing with alcohol, television, manic exercise, overeating, or even prescription drugs.

Notice that these questions, unlike the MCAT or the USMLE, don’t have “right” answers. They are simply ways to observe and fully accept where your mind has attached to painful beliefs.

“If you correct your mind, the rest of your life will fall into place.” – Lao Tzu

First things first – question your thoughts. Look at the mindsets that brought you to this point, and recognize that Einstein might have had a point when he said, “You cannot solve a problem with the same mind that created it.”

This has been a long road for me to learn and practice. And there is plenty more on the road to creating a life you love (like dreaming and working your ass off). But it starts here. Right at the beginning.

About the author:

As a life coach, musician, writer, teacher, and speaker, Lisa Chu, M.D., supports and encourages adults who are seeking to live more creatively and passionately. She completed medical school, but left medicine before doing a residency, in order to follow her dream of creating a life of passion, creativity, and authenticity. She has since been a partner-level investment professional in a venture capital firm, the founder of her own violin school, the creator of music improvisation workshops for personal growth, and the co-creator of an acoustic rock band. Learn more about Lisa Chu, M.D. here.