One night on one of my last call shifts of Fellowship Training, one of my nurse practitioners confided in me that among an increasingly uncomfortable situation with staffing, feeling overworked and being overall exhausted from the rigorous 12 to 24 hour shifts, she planned on quitting. Somewhere in her early to mid-50s, many in the United States might traditionally consider this too early, but for her, it feels like it might be later than she’d wanted. Times are changing, many workplaces in America seek productivity, especially in healthcare, to prioritize revenue and efficiency over wellness and balance. Meanwhile, in many other countries, incorporation of siestas, 4-day work weeks, or maximum hourly shifts are focused on with the realization that happiness and balance lead to longer lifespans, preservation of families and communities, and ultimately the continuation of human evolution. Commonly as an example, many Europeans think many Americans work too hard, while many Americans surely think the opposite.

In the 1990s, a book came along titled Your Money or Your which completely revolutionized the concept of aiming to retire at 65 (which by the way dates back to the 1930s in the US but the history internationally on it’s adoption is worth the search and self-fulfillment of understanding). Thus began a newer concept of balance, at least for the United States. Flash forward another 20 years to ~2010 or so right at the height, or slightly after, of online blogs (I love that you’re coming to mine to read this, but let’s be honest, the “kids” these days are probably not reading this and probably stuck to social media – which, by the way, if anyone would like to collaborate on my future plans for this, please message me 😅) when Mr. Money Mustache came along and coined the idea of FIRE – Financial Independence, Retire Early. It’s not all about working yourself into the grave, anymore… And, as we live longer and longer – we have come to outlive the number 65 – and the concept of ‘retirement’ and ‘savings’ needs to be entirely reconsidered.

With the increasing focus now in 2026 on mental health, balance of life outside of work, and the growing epidemic of chronic health issues in an economy that is ever volatile as the environment faces depletion with our focus on technological advances and concepts like Artificial Intelligence (which, by the way, i never use in ANY of my posts other than to generate fun cover pictures), more and more people, especially in the younger generations, have adopted the concept of FIRE and it is spreading, very ironically, like a wildfire.

What is important in life? What is the purpose of life? What do we hope to accomplish? Do we intend to leave something behind? Is our legacy created by actions, by children, by materialism? What actually matters and what IS happiness?

I paused as she told me of her alternative plans to become a farmer, something I not jokingly, discuss myself with coworkers from time to time – although I hope to herd Alpacas as opposed to grow crops, primarily. It was once rare to consider an ideology that I have come to love: the concept of multiple careers in a lifetime. The point being, that as the FIRE movement has continued to spread throughout the country and the world, the age at which it is focused on decreases. Increasingly mainstream new posts/journals discuss the concept of FIRE, but as the youth in the active workforce prioritize this concept, the realization of “what to do after” starts to hit, and so does depression, anxiety and possibly loss of meaning – what really IS there to life without meaning?

I often think back to my 2nd year of Fellowship when I saw an older face in the crowd of new Nurses I was giving an orientation lecture to on managing fluid status in Neonates – she raised her hand to ask a question of genuine curiosity, and I realized this was not only her first job, but this was quite a different one than she’d had before. Shortly after, in the middle of the night as I made my rounds around the unit, I stopped by her bedside, re-introduced myself and asked if she’d been a nurse elsewhere before, “Nope! Would you believe, I JUST became a nurse?” A prior accountant that had decided in her 50s to go back to school to become a nurse after living a life of retirement as an expat in another country coasting off of earlier life successes and investments, she said something so profound to me that she read about in a book (Halftime: Moving from Success to Significance), the idea that “the first half of your life you seek success, the second half you seek significance.“

I have completed 26 years of formal education and it won’t be until shortly before my 37th birthday that I will finally be able to call myself a Neonatologist. It is by means not an exaggeration to say that those of us that have chosen to become Physicians, have dedicated our entire lives to Medicine. It is not a secret that as the world changes, the balance between work, life, and satisfaction becomes more difficult, more murky, and depending on your goals, focus and background, more confusing. My program director has asked me multiple times what I will do after I graduate, and as this blog has transcended simply writing about Locum Tenens, my answer has as well: Well, hopefully i’ll figure out what there is to life outside of medicine, hopefully I can finally Live.

I love every moment of my job and sink into the vulnerability and magnitude of touching and affecting lives. I am fortunate to have a journey that has taken me to many places and has brought both success AND significance at the same time. But… I have sacrificed relationships, stability, sleep, and am the first to admit that my balance is likely the most skewed among many. At my peak as a Pediatric Hospitalist prior to returning to fellowship, I traveled 359 days doing locum tenens – was the quest FIRE or addiction? However, beyond paying off my crushing $315,000 in student loans, I found a way to save the equivalent of what the average American saves by the age of 50. Money was never the sole reason to choose Medicine, but burnout, frustration and loss of autonomy are never good reasons to stay. I hope to find for myself through Locum Tenens a way to prioritize my life, my income, my freedom and my meaning. As I balance the future of seeking FIRE with maintaining my significance and discovering the impression I hope to leave on this world, I look towards the horizon with white eyes and inwards with a questioning gaze as to what really is Purpose? Maybe the idea of Retirement is overrated, especially if you love what you do.

Imaged Credit: ChatGPT