There is a reason that this blog is entitled “postdoc wanderer.” It is not only meant in the geographic sense, with tales from verdant Bangladesh interspersed with commentary on conferences in preventative cardiology. This wandering pervades each aspect of career and life. Not a day goes by when I do not have a conversation, generally over too-bitter coffee after having received a revision of a paper with more red lines than text remaining, when my fellow fellows and I are not contemplating the disintegration of our grand plans.
At this stage, shouldn’t the future have some trajectory? Some white lines painted on terra firma, hastening us towards an unforseeable, yet solid goal? Unfortunately, the fault lines that separate potential decision paths have neither reason nor schedule to their tremors. Each side of these deep rifts take me in such divergent directions that there is little in common between them, and decisions on which to pursue have to be made early enough so that I am not stranded, wide-eyed and unprepared, on the wrong side.
In medicine, people have choices, in prevention, in treatment, in doctor whose advice is sought. The hardest things to grasp and in which to proceed successfully are those that require you to decide upon and alter your own behavior to reduce the potential of a problem. When the HIV diagnosis has already been given, there are certain clear rules to follow, habits to change, pills to take once or four times a day, and a new understanding of impetuous actions and their consequences. If the tagline to care, however, is “if you continue to live this way, there is a likelihood that in 25 years you will have a heart attack,” how many of us will actually listen to our own internal reason, or incessant badgering of our primary care physicians, to change things for a future that is still uncertain?
The 10 and 20-year plans that we are increasingly encouraged to formulate, whether for our own health or career or personal happiness, are seemingly written in invisible ink; when you step on one lighted square platform, only the very next one will begin to glow and show itself through the haze. It feels like swimming blind, staying afloat at any given moment but with only a vague idea of the ultimate trajectory. We are required to amass concrete successes, yet use these to gamble on a future. If no great risk is taken on choosing a direction, this aimless drive and passion becomes a character flaw, something to be spoken of in whispers laced with awe and fright.
We change our behavior to reduce the chances of a heart attack, never knowing whether it will or it will not develop, or whether it would have if we had not stopped eating butter or forced ourselves onto the elliptical each day. This is the peril and the pleasure of choice. It can be alternately frightening and successful. Which one it will be, however, is entirely unpredictable.
The wise answer to this stalled energy, this trepidation associated with stepping firmly to one side of the rift, is that the boundaries of the path chosen are not severe, and it does not forge ahead in isolation. It will always intersect with others. The process of creating a trajectory is iterative, and influential decisions are based on daily opportunities and new relationships for which we need to both be patient and actively pursue when they appear. Stephen Colbert once praised a past President for believing “the same thing Wednesday that he believed on Monday, no matter what happened on Tuesday.” Take a chance, but when it fails tomorrow, revise the plan and keep going. Make friends while you travel as they often bring new options into your life. And look both ways when you cross another path…you just might want to make a turn when you see where it leads.