On escape

I recently returned from a beautiful and therapeutic trip to Puerto Rico with my husband. This was our first long trip without kids in about 10 years. And while there are many wonderful things to say about the opportunity to be in sunshine and warmth, experience the sea and beaches, and enjoy the privilege of having food prepared and served to you, the thing that has carried with me most strongly is the relationship between escape and my deep urge for space and ease. 

Let's start with the latter, my deep desire for space and ease. I, like many people in medicine and larger society, have been conditioned to obtain much of my worth from my work, output, productivity, status, titles, and accomplishments. It feels a little embarrassing to admit that outloud; it doesn’t sound humble or altruistic. But it's true, and I know I’m not alone. And I know that it would be a mistake to over-simplify these truths and conclude that these motivations are antithetical to humility or altruism. I went into medicine to serve others, to make a difference, to heal. I love caring for my patients through difficult moments. But I also know that in the process of getting there (here), I became conditioned to work for the approval of others, to seek advancement for the sake of advancement, to hustle, to prove I am worthy. 

However, over the last several years, as I have crept my way out of burnout, exhaustion, insecurity, etc, I have found that a part of me deeply desires something that medicine left out: space and ease. Practically, for me this means time for unrushed walks, looking around my yard at the first signs of spring, imagining and thinking, moving my body, being present rather than always thinking about the next thing. Implementing this, committing to this, has been a hard and difficult practice full of false starts and steps backward.

Enter, vacation. Most people probably see vacation as a place for ease and space. Those people don’t have children. I kid, but really, most of my time off in the past 10 years has been with my wonderful, yet developmentally appropriately loud and busy children. I love them. And also, I have not necessarily seen vacation as a place for space or ease, which is why some people call traveling with kids a trip. 

My husband really wanted us to spend some of our vacation on the island of Vieques. I was hesitant, as it took extra effort to get there. I knew I wanted ease on this trip. An escape. We went to Vieques, and it was, in fact, extra effort to get there. But wow, it was beautiful, with beaches unaltered by development. Warm sand and sunshine. As the days went on, I felt a growing ease. That tightness that can settle in my chest on a regular work day was gone, and I wasn’t thinking about all the things that were left un-done at home. It didn't matter what my title was or what accomplishment I had made the week before. I was present, at ease. 

During this awareness, I read an article on Substack by Kristin Powers. She was describing a recent choice to move to a rural area of Italy. I want to start by saying that I have no judgment about her choice, and in fact many of the challenges that led to her decision resonated with me. While the reasons for her move are many and likely surpass what she shared, the article centered around her feeling fed up with the general sense of rush, hurry, workplace culture, consumerism, and lack of social safety net.

In many ways, she was listing the same things I’ve been trying to escape over the past few years in big and small ways. The things I escaped while on vacation. The conditioning of culture and medicine that orients my attention toward my productivity and output. My to-do’s. How I measure up to others. Whether I’m doing enough. On vacation, I felt the tight pressure of those expectations literally leave my body and mind, and experienced the ease and presence I yearn for at home.

But, her own personal choice to somewhat permanently employ the escape hatch left me with many questions and feelings. When we escape, what happens to the people who can’t? Is it ok to utilize our privilege to escape to maintain our own well-being? Physicians considering leaving medicine probably ask these questions, too. These questions are important, and are worthy of deep contemplation, but the question that has stuck with me most is this: Can I, can we, experience ease, space, and presence in the midst of this culture? Do we have the capacity to create spaces and habits where we can slow down, to feel emotion, to connect, to dream, and be creative amidst our American  lives, AND while working in medicine?

I know that I dream the answer is yes. I choose to believe it is yes. I’ve seen it show up as a yes in my own life. This yes is what motivates me to keep making space. To listen to my need for quiet walks. To create spaces for others to self-reflect, dig deep and dream. My hope is that rather than escape entirely, we can see that but rather that moments or weeks of escape remind us what is possible. Remind us of the parts of us that are not valued explicitly in the current cultural norms. Because in that space, we can imagine creating something different, and imagine a world, or a healthcare system where we don’t need to escape.

As an ending note, I 100% advocate for taking your vacation time!