The Next Chapter

Monday, October 17, 2022


Hey. A year later. A year wiser. Another year of missing writing for pleasure.

My first job as a physician assistant has come and gone. Two+ months into the new one, and I'm still mourning in some small ways. Because what I thought might be my forever place in medicine was not. I felt like a failure, a quitter, a fool. The fact is, it wasn't what I thought it was and probably never would be. Hardest of all, it wasn't what I dreamed of all those days and nights while I was still in pursuit. The dream that pushed me to keep chasing the goal, even when it took more than I had to give. If I'm honest the reality of the situation set in early, and during my time trudging to the one year mark I focused on gaining all the experience I could. It was a way to push through profound feelings of disappointment while still feeling like I was accomplishing something. I gave the obligatory 3 month notice, which served as a very slow wind down to a hard 1.5 years. Enough time to be logically sure about my choice and simultaneously emotionally fraught with what-ifs. 

I'll say this: I learned so much about what I need from this career. What I want? Well, I'm still figuring that out. But my needs, the fundamental requirements to stay healthy in the working world? I'm much closer to understanding those. If I was to sum it up in one statement, it would be this: There must be equity and well-defined boundaries between my work life and personal life. 

In mid-August I said my farewell to one job, and started (with a lot of trepidation) the new one. I had two-ish weeks off in between, which felt like enough time to a take a major leap: stopping my antidepressant of over a decade. I had been in weekly therapy for 9 months, the type where every faulty thought process as an adult was an opportunity to delve into its origin within my childhood. At that point I was clear on my motives as a human, and needed to move on to the phase where I actually did something about it. Alterations in lifestyle, mindfulness, and habit changes up the wazoo. It was time to stop talking and start doing. The thing was, I was living an emotionally blunted life. 

I have been on some sort of antidepressant medication most of my adult life. It started in my early twenties when I was having hair-on-fire anxiety on the regular. I just couldn't figure out how to stop worrying, ruminating, and reacting my way through life. And because my bandwidth was already used up, I turned to medication. It blunted my emotions, which I didn't hate, but the anxiety continued to burn through me. I tried doubling my dose this February to no avail, at which point it became abundantly clear that what I needed was some serious lifestyle changes. 

I'm going to pause here to say this: don't discontinue psychiatric medications without professional support. Don't do it cold turkey. Don't do it without a plan. These medications are a lifesaver for so many, and offer a tremendous value in the world. If it becomes necessary to resume taking them, I will do so without shame. I have no regrets about taking an antidepressant and neither should you.

To sum it up, it didn't go well. The withdrawal period came with severe side effects, which I wasn't anticipating, requiring me to start taking it again so I could wean off even slower. What's more, a lot of unpleasant feelings were unroofed in the process. Old resentments I'd been carrying about my relationship bubbled anew to the point that it almost became unbearable to be around each other. I had never defined who I was as an individual in a relationship, and it had finally taken its toll. There were many moments when I almost started taking the medicine again, knowing I had not given myself a proper chance to see what lies beneath. I was miserable and didn't like who I had become without it. Because emotionally blunted was better than whatever this was. I was being swallowed by all the assertions I'd never made, all the realizations I'd never come to, all the boundaries I'd never set, and all the hard admissions I'd never said out loud. I was beside myself with fear that I was an angry person who had made all the wrong choices.

Fortunately I'm through the worst of it.

I realized I was done digging. That it was time to set the past down and move forward. Two weeks ago I said goodbye to my therapist. I'm leaning into things like reflexology, reading for pleasure, and (!!!) writing again. I've been contemplating finding a different kind of therapist. I don't know what raw, unfiltered version of myself will emerge when the dust finally settles, but I think I'll like her. She puts up with a lot less shit. 

As far as my career, there are no regrets. There is however, a lot of acceptance and grace these days as I start to admit that what I pursued for 12+ years doesn't fill my bucket the way I thought it would. Perhaps I'll find my niche in medicine with time and experience, a place in the field that makes me excited to go to work everyday. Then again maybe not. My current job is allowing me to pay off my student loans more quickly, which means in a few years I'll be free to choose less of this or more of something else. Time will tell. In the meantime I'm learning more than I thought possible; I've become a significantly better PA over the past 3 months. These days I can participate in continuing education courses and create charting templates on my days off, and I don't feel like work is stripping me of my soul.

Here are some things I know for sure: nothing is permanent. I can walk away from something that doesn't serve me at any moment. I can change my mind and it doesn't make me a flake. Hindsight isn't always 20/20. One day at a time around here. As I slowly emerge from under the weight of the past few months, years, and decades, I see that life is always opening new doors.

I'm much less afraid to admit I didn't have it all figured out. 

As a result of this process, as hard as it has been, I'm slowly beginning to feel less anxious. Because once you embrace the idea of failure, begin to see it as a normal part of life + success, it no longer holds the power over you it once did.  The solution is to say "I didn't know, but now I do" and move on. 

I've missed you, friends. More to come.

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