It was such an odd and humbling feeling standing before a crowd of 30-40 Family Medicine Residents (and possibly some medical students that had happily snuck in) at the AAFP Conference in August 2024 to discuss my time as a locum tenens provider at a special happy hour session hosted by LocumStory.com – Especially given it was in Kansas City, Missouri and I was a Fellow training in Neonatology of all things, a field fairly distinct and relatively far away from Family Medicine. My life has always been full of conundrums, amusingly confusing, and consistently unfathomable. There are many days that I just accept how things have gone, and I am always grateful for where I’ve landed. I love the concept that you are exactly where you need to be. I imagine most of us spend a lot of our time thinking “what if” or contemplating the “purpose” of good or bad things happening. At the moment this is being written, I find myself in a small coffee shop about 30 minutes south of Kansas City, Missouri taking a break from studying before going out country line dancing for the night on my research month, and frankly I wouldn’t have it other way, most of the time. However, I do like to engage my imagination on the theory of an alternate timeline.

In one of my favorite TV series, Community, there’s an episode in which the group rolls a die to determine who has to get up from their card game to get the pizza delivery. By nature of the fact the die can land on any 6 of the group, therein lies 6 possible ways the pizza can be picked up and subsequently 6 different ways the story ends. Flashing back and forth the episode imagines the possibilities from drab uneventful outcomes to exaggerated cynical disasters, and ultimately, the die lands on a crack at an angle and the path fades away into an unexpected 7th ending.

There are so many arbitrary branching points in our lives where we roll the die; some are more obvious than others and some are more discreet or clearly louder and significant. One day, i tell myself, I’ll connect the dots through the major and minor branching points and paint a beautiful constellation of the life I’ve lived… One day. But, the ricocheting scattered contrails and pathways that disappear into the ether are the more curious paths that I’ll never see the answer to, nor will any of us. Growing up, it was always fun reading the “choose your own ending” books because you could always flip back and see what would happen if you had chosen the other ending; but, with life, you really can’t do that can you?

So many days pass when I wonder if I had chosen not to go to Italy in 2011, if I would have ended up in Medical School somewhere else or not at all? If i had waited or chosen to apply to medical school at a different time would I have found myself restrained to California as opposed to exploring the richness of Louisiana? If my rank list for Residency had been different what my life would have been like learning to be a Pediatrician in Memphis, TN or Oakland, CA or Phoenix, AZ as opposed to Houston, TX? I wonder who my friends would be, maybe i’d be married, maybe i’d have kids, or a dog? Maybe I would have never met an alpaca and found myself instead wanting to eventually have another life as a fisherman?

Locum tenens has given me, time and time again, a reason to explore farther than I am ready for and am aware I can. It has pushed me to exceed the boundaries of things I know of and create endless branching points and therefore also contemplate infinite alternate timelines. I suppose it’s all rhetorical in the end, and as redundant as these posts become as I trail away in circles seeking my own self-understanding on these blog rants, what I find always fascinating about it is pretty simple: Currently, I’m actually living the alternate timeline after all.