I remember the day clearly.  I was sitting in my living room with my dad, crying.  Seemingly out of nowhere, my marriage was imploding and I was in a high state of anxiety.  I was working two part-time jobs, one clinical doing college health and the other in medical education, was a mom of two young boys, with the same invisible burdens that all working moms have, and then this.  How could I manage everything? It seemed totally impossible. I wanted to try to save my marriage, but had no idea how I would do it on top of everything else. My body was just as overwhelmed with the thought as my mind and spirit were.  

Fortunately, my dad is a psychiatrist.  After a lengthy and tearful monologue, I asked him if I should take medication to help me with my intense feelings of panic and anxiety.  I remember his response clearly. He looked me in the eye and said, in his accented English, “Pami, why do you want to take medication when you can make a change in your life?”  That comment forever changed my perspective. He was right. I actually could make a change in my life. Even though I felt like my life was spiraling out of control, I did have some things I could control.  And while my anxiety didn’t totally resolve, it suddenly became bearable. I did have choices, I just had to take some time to think about them.

I first considered my priorities.  There was no question – my number one priority was my family.  I would do whatever I need to do to keep my family together. That meant my professional life had to change.  I had to choose. Would I continue my patient care job? Or would I continue my medical education job? How did I want the next months of my life to be? Which of the jobs would give me the best opportunity to shift my energies where they needed to go, while still giving me a sense of fulfillment?  It wasn’t an easy choice; there were things I loved about both jobs. In the end, though, I made the difficult choice to give up patient care.

That decision is never an easy one.  We physicians go into medicine with a passion for science and for the human body, and for helping others heal.  We all know that being a great physician is about more than just medical knowledge and problem-solving; it is about communication, connection, and empathy.  Yet, I knew that at that point in my life, I could not devote myself to healing others. I could not be the physician I wanted to be and that my patients deserved.  I needed to heal myself and my family first. And for that, I needed time.

As soon as I quit my patient care job, it seemed that I was able to take the first real deep, restorative breath I had taken in a long time.  When I walked out of the office, I had a new sense of hope and possibility, as well as conviction that my future would be better and brighter.  With that choice, I was able to start truly taking care of myself and I spent time in both individual and marital therapy. I had regained some control of my life, and I noticed that with every bit of control I felt, some of my anxiety ebbed away.  

I wish I could say that the sacrifice resulted in a happy return to marriage. It didn’t. But what I can say is that I did everything I could and I have no regrets.  I am better, happier, and stronger than I have been in years. And my focus on medical education has led me to new professional opportunities and passions, and to a full time associate dean position, working with the next generation of physicians. For me, for now, that is just right.

I will be forever grateful for my father’s words.  Those years ago, when I was so stressed, anxious, and panicked, he helped me see that I had a choice.  I chose to put myself and my family first. And while my life is not what I thought it would be, it is more than I ever could have imagined sitting on that couch.  

Will I choose to go back to patient care, now after these years?  I don’t know. If I do, it will be as a better, more holistic, more empathic physician than I could have been before.  Either way, I know I will face whatever the future has in store for me with strength, with grace, and with a smile. Because that is my choice.

Pamela Ludmer, MD MMEL is a Med/Peds and Adolescent Medicine trained physician, who is now Associate Dean of Curriculum. Her Twitter handle is @PLudmerMD