Throughout my life I have taken many introspective breaks to remember the moment I’ve walked out of each job, training situation, or new experience. From my first job at Roundtable Pizza, to dancing in a Second Line after medical school, to an anticlimactic walk out of the hospital in residency after a zoom graduation, I remember each moment in a visceral bright and emotional way. Working in locum tenens, jobs are quick to come in and fly out. Whether it’s one shift, a full week, or a year of monthly recurrence, it can often be equally as sad each time to leave a new position. I wanted so much to have personal detachment from jobs I knew wouldn’t have longevity but have instead spent so many “last days” genuinely saying my goodbyes to those that I may not have known for more than a few weeks but that i will remember for the rest of my life. Over time, I’ve stepped back to ask myself exactly where these feelings and emotions come from and why I am so quick to get attached to people and places, and one day had a revelation of why no matter how much I try to be a fleeting presence, I am unable to leave without a deep imprint on who I am as a person and as a physician. Simply said, I always put my all, and I never believe in half-assing something.
It was the end of a short job in Boston when I remember the Charge nurse coming to me to bring up a systemic issues she had noticed on the way that the weights were being obtained – we weigh babies daily because… They really have one job other than not dying: Growing. She had noticed that there was a discrepancy in the time of the day that people would weigh the babies, which could have some element of effect on understanding the overall weight trends of each one, especially approaching their discharge. She began to tell me her thoughts on this on my last day of work and quickly stopped to say, “Oh, wait, why are my telling you, you don’t care.” Ah, but I listened and curiously kept in mind her concerns promising to pass them on to my director. As I told her, I might be leaving, but i wasn’t here to do a bad job, even on my last day.
It is easy to not care about something on the last day that you have to care about it. I suppose there are two types of people in this regard, and I suppose the biggest factor is how one might want to be remembered, but on a greater perspective the concept of legacy and leaving some sort of positivity in this world. The characteristics that make someone a good worker or inspire them to reach the finish line are always the same. As a kid in karate class the acronym I was instilled with was C.A.N.I. = Constant And Never-ending Improvement. As a highschool student, I heard my classmate give a Valedictorian speech ending with the phrase, “Let’s go, and set the world on fire.” For those of us so inclined and inspired to go towards medicine, hopefully there is always some sort of fire of motivation to make the world a better place and to contribute to the world.
But really, regardless of one’s own moral institutions, I have learned one thing: It is impossible to leave something quietly if you have contributed to it voraciously. At the end of the day, I have approached every single job, situation and opportunity fully and openly. Putting my “110%” has never been good enough; it has always been at least 200%; and, when you put that much of your heart in dedication into something, you grow dedication and loyalty. So whether my first day or my last day, if I am able to find a way to fully contribute my life and my livelihood into what I’m doing, I am unable to leave quietly, and noone should leave quietly. There are those that may skate by, but I hope to never go gently into any night, good or bad.
The Nomadic Pediatrician 