On quitting a calling

I quit my job as a healthcare worker because, well, I wasn’t happy.

What surprised me the most after quitting, was the chilly reception I received from some of my peers. Sure, early retiring in one’s forties is unusual, but not particularly offensive, right? I wondered what was driving the mixed bag of responses when I stepped away from my field.

And then it hit me.

You don’t leave a “calling”.

Leaving my job was an afront to a lot of people. People who believe that this job held the moral imperative of a calling. I had unwittingly violated a cultural standard, and now, the moral imperative police felt weird about that.

There is a pervasive idea that certain professions are 100%, across the board, full-stop callings for everyone in them. Doctors have this expectation, as do pastors, teachers, nurses, and a whole host of others. Professions that we collectively and culturally deem as “calling professions” tend to be ones in which the professional must give of themselves, no matter what, in order to carry out their duties.

Even if you are sick, even if you have a family, even if-deep down-it really isn’t a calling for you, you must give all. Because, whether or not you think it’s a calling, everyone else will impose that assumption on you. If you don’t fit that picture, then you have somehow violated the “moral imperative” of being in such a profession.

While there were times during my career that I felt that sense of duty to my profession no matter what (like my time in public health), overall, I never saw my job as a calling. In spite of this, I managed to uphold standards of care and ethical practice (perhaps you can hear my sarcastic tone). In spite of this, I had great rapport with my patients and colleagues. Also in spite of this, I still felt the pressure (….or was it guilt…) to put my needs to the side day after day in service to the profession. Which literally made me sick.

Incidentally, I would then come home and feel the same pressure to do that as a mother. Which is also not something I see as a calling. Of course, it is a spectacular part of my life, but naming it as a calling adds monumental pressure that frankly, modern western women do not need (topic for another day,  perhaps?).

Again… I don’t fall into the pervasive narrative; therefore, I am suspect.

Diving into multiple Reddit threads on the topic, I discovered that I wasn’t alone. Virtual anonymity makes for a lively debate on the topic.

In online forums, I saw that there will always be people who feel called to a medical career, but there are plenty of people who, like me, view it as a job. Many of us end up in medicine because we were decent in school. Cultural narratives and family expectations directed us to this path…one that was honorable, respected, and could support us financially.

The feeling I got when I read some posts is that viewing a medical job as a calling actually makes you vulnerable to being taken advantage of. Because, in a calling, you must give all-regardless of the circumstances. A calling requires that you work within dysfunctional systems. A calling requires first priority even if personal life suffers.  

In a calling, we MUST give…yet the very systems (and/or cultural narratives) in which we give never seem to get enough from us. There is always more we could or should be doing.

While reflecting on this, I happened to have an eye-opening conversation with someone I met recently.

This gentleman had been in a relationship with a person struggling with addiction. As a result, he started attending support groups. Through these support groups, he learned about a concept called codependency.

Codependency describes a relationship wherein there is one caring, high functioning partner (the giver) supporting another partner (the taker). In the case of substance abuse, the giver only perpetuates the taker’s issues by constantly bailing them out. For example, giving a room to an alcoholic friend who has hit rock bottom. Support groups for people in relationships with addicts often focus on setting boundaries; they learn that constantly giving of themselves hurts all parties.    

It struck me that the cultural narrative of medicine as a calling institutionalizes a codependent dynamic. The doctor as the giver and the broken, profit-driven system as the taker. As in all codependent relationships, the taker has no need to change so long as the giver is always there, ready to clean up their messes.

Strangely enough, this dysfunctional relationship crowds out the people who really need help- the patients. But so long as professional autonomy is wrapped up in the dance of codependency, the patients will continue to lose out, their role peripheral to profit and the status quo.

The time that I did see my job through the lens of a calling, when I worked in public health, money was not the central theme of the job. There wasn’t an eye towards profit, but rather towards expanding access to underserved communities. In that circumstance, my job as a calling was more natural, lighter, and voluntary. I wasn’t guilted into it or manipulated by moral imperative. I simply had the skills that people required, and I did my best to meet them where they were at.

At the end of the day, I left because I wasn’t happy. I wasn’t happy working in systems that worked less and less for the average patient. I wasn’t happy to give more when I was already exhausted. I wasn’t happy feeling guilty when I could never meet the expectations of the pervasive moral imperatives.

Nowadays, when I run into old colleagues, the first thing they ask me is if I miss it. I tell them I miss my patients, which is the truth. But I don’t miss the codependent dynamic, the guilt, the exhaustion or the burnout.

The second thing they ask me is if I would ever go back. I say no. But in my heart of hearts, I would love to do good work in a better system…one that doesn’t ask me for every last drop of my humanity. One that doesn’t need to guilt me into staying later or doing more. One that works for everyone

 

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