Moving on

Sometimes it seems my life turns on simple decisions that have profound consequences.

In my first year of medical school, I participated in something called “day hospital” at the local VA. Think of it as a sort of psychiatric halfway house, a place of refuge for vets too healthy to be hospitalized full time, not so healthy that they could manage to fill their days productively. One of the staff psychiatrists got to know me well, and he knew I was engaged, soon to be married to a young woman with serious health issues. He asked me if I had any reservations.

I told him no, no reservations at all. I told him I was sure of myself; I didn’t have a glimmer of doubt. He didn’t ask for an explanation, but if he had, I would have said that if you love someone, you stick with her no matter what. Nowadays, I would go on to qualify that blanket statement with “assuming she holds up her end of the deal, too,” but since Karen has never dropped her end of the rope, the point is moot. But, yeah, I still feel the same way.

The next simple decision came in 1998. Karen and Jake were shriveling in the Texas heat; my research career had “doomed” written all over it; the Dean of the medical school kept making noises about changes which would have shaken our financial bottom line. What to do? Move, of course, preferably to a better climate. Go into business for myself so that I would have some control over my income — I would no longer be at the mercy of a Dean who cared more for politics than his faculty. On the day when my mail included an ad for an ENT position in “the rugged and beautiful Pacific Northwest,” I knew I would have to answer it. And when we visited Crescent City, we left 105 degree weather for 70 degree weather, scrubby oaks for redwoods, wasps and fire ants and scorpions for seagulls and frogs and caterpillars.

Easy decision? You bet. But living with the consequences of that decision was anything but easy. First, I had to tell my chairman, whom I loved, that I was leaving. (And I had to tell him this two years after assuring him no, I wasn’t one of those flighty assistant profs who couldn’t commit to an academic program. At the time I made that promise, I believed it. But blood trumps loyalty to the boss . . . even to a great boss.) Second, I had to digest the idea that I would never be the research scientist I had always dreamed I would be, ever since single-digit childhood. And that was tough to swallow. It ate me up inside for several years, in fact.

Well, it’s decision time again.

This area isn’t meeting Karen’s medical needs. I’m not sure any area will meet her medical needs, but I’m sure this area never will.

This area isn’t meeting Jake’s educational needs. And on this point, I know for certain that other areas will surpass the opportunities so sorely deficient here.

He’s 12. He’s working at about the level of high school sophomore or junior. We’re already teaching him from college textbooks; in two years’ time, he’ll need a real college for his coursework. What do we do then — send him away, a 14-year-old? I don’t think so! Do I send him off with Karen while I keep working here by myself? That might have been doable before Karen broke her pelvis in ’05, but not now. She needs me too much.

So we can’t break up the family, not that I would have ever wanted that, anyway. No other choice but to move to an area which can meet Karen’s and Jake’s needs, both.

Right now, we’re looking at anything from San Francisco up to Seattle. I’ve interviewed in Santa Rosa, which is a little too warm, but still better than Los Angeles (and Karen survived that for six years). The Santa Rosa position has the advantage of being with a guy whom I’ve known since med school. We’ve had a professional relationship for nearly ten years, and we have a lot of mutual respect. Santa Rosa is also close to family and friends.

Seattle would also be close to family and friends (including my pal who set me up with Karen), plus the climate would be better for Karen. I wouldn’t be working for someone I know, however, and that’s a significant minus.

Ultimately, the educational opportunities for Jake will probably be the deciding factor.

Meanwhile, I’m going to have to deal with the fallout of this decision. I told my office staff today; that went surprisingly well. I suspect I was far more upset about telling them than they were at hearing the news. (Who knows, maybe they saw it coming.) I still need to tell the hospital. (Although, depending on who reads this tonight, I might have just told the hospital!) They love me there. Well, most of them do, anyway.

Worst of all, I’m going to have to let my patients know.

I’m the only ENT for 70 miles around, and the guy 70 miles south is overworked and overbooked. If you live in Brookings, Oregon, then I’m the only guy for 100 miles. And what if you’re too elderly to travel that far?

And, honestly, I’m a wonderful doc. Who would want to give up a great guy like me to see someone they don’t know? But they won’t have much choice. Oy, it’s going to be painful.

And then there’s what we’re leaving behind.

This is our view. And then there’s this

and this

not to mention this

and have I mentioned our view?

Oh, well. One way or another, we have to stay in the Pacific Northwest, because it’s the only place with a tolerable climate for Karen. So I guess we’ll never be too far from all that natural beauty.

The patients, that’s going to be the worst bit. I hope the hospital finds a good replacement for me soon, but I know very well how tough it has been for them to recruit.

This is a big deal for me, folks.

D.