OK, Docs. This is what I see. I’ve been reading the blogs, studying the published research papers, checking out the advice you’re giving each other for dealing with the health care system. I hear you. There are many things about the system that seem broken. You are tired. You feel overworked and underpaid, and when you look out on the horizon, all you can see is things getting worse, not better. You feel powerless and voiceless as other stakeholders make policies that have a profound impact on the way you do your job. You see your job as sacred. You went into medicine not just for the money, but for the nobility of doing something good for other people, and for society. You feel that your job is special. It's more than just a job. You think it's not so unreasonable to expect to be rewarded for your efforts and personal sacrifices. Now you’re being herded like cattle into a holding bin, while still being asked to hold yourself to the idealistic standards that you believed when you went through your white coat ceremony as a medical student. I’m not in your shoes right now, but I offer the perspective of an observer. I did go to medical school, and saw too many of you around me who were burnt out and walking around like zombies during the most vibrant years of your life to want to be like you. So I chose to walk. Some might say I copped out. Others might say I made a wise choice, getting out early. I’m not here to debate my choice. I’m here to offer you a different way to look at your life. I’m here to remind you that you can choose, over and over again in life, no matter what other people tell you. No one in my life ever told me that I could choose what to believe, and that this simple (but by no means easy) choice could give me the power to change my life. Maybe it was assumed that the minute I stepped out of my parents’ house, I would adopt a whole set of independent beliefs based on being “out there” in the world. It wasn’t like that for me. Long after I left home, long after I left school environments, I was still unconsciously believing things that I had never stopped to question. They ranged from simple things, like, “You’ll never get a good job right out of college, even if it’s Harvard,” and “You’ll never make a living as a musician,” to more complex things like, “Life is just a series of tests. You win some, you lose some. Hopefully you win more than you lose. Then you get weak and die.” Sure, it may look like I’ve broken down many beliefs in the process of making some bold changes in direction during my life. I said “no” to a residency, I actually did get a job out of medical school (and it paid really well), I believed in myself enough to move across the country to follow a dream. But I'm beginning to see that it doesn’t end with just taking the big steps. It’s the little steps that count even more. The many small decisions you make in each moment of each day add up to your experience of life. Time is simply the sum of many present moments. And if we remain unaware, these moments still go by without the benefit of our attention. I’ve been trying to strive for “the next big step” in my life for quite some time. I’m just beginning to learn what it’s like to take the tiny ones. I’m learning what it’s like to celebrate myself, before expecting others to celebrate me. I’m learning how to listen to myself, before I run out to check if someone else will tell me I’m doing it right (usually I expect to be wrong). I'm learning that there's nothing wrong with being wrong, as long as I am open to it and keep learning. I’m learning how strong my muscles of self-care need to get, in a culture built on teaching us to face outwards and seek any sign of reinforcement, even if it’s a blinking red light on my Blackberry, or one more follower on Twitter, or an upward-sloping line on my web stats page for today. Looking inward at yourself, asking the questions that can be answered only with the heart’s truth, and sitting with your own answers – I believe these are some of the hardest jobs on the planet right now, no matter what you happen to do to earn your paycheck.