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To all...yesterday....I was offered the job...and I accepted. My days of helping sick people are now coming to an end. I am nervous. For most of my life, I've made pretty good decisions. I guess, the exception is...well...pretty obvious by being here. Counting surgical residency, I have spent the last 23 years of my life tending to the sick. I've been hugged...thanked...received gifts. I've lost patients after surgery..held a human heart in my hands as I desperately tried to save someone's life. I tried, as a team, to save the life of a little 12 year old girl, hit by a motorcycle..during the first month of my residency. I still tear up as recall the blue color of her eyes turning to gray...and..the little gold floret pierced earrings she had on....as she passed away on the table. The pain is real....and I still carry it.

I giving this away. I hope I am making the right choice. I will answer kmls questions in a bit...my son wants to have a catch.

FIB

FIB...

No matter what this procedure you'll be doing is, you are still helping people. Helping is helping...and there are no degrees of value if you are in that space. Additionally, from what I hear you say on this board, you are helping your kids and yourself have a better, more peaceful life.

It is easy for us to glamorize certain jobs and situations. Me, I'm a teacher, and Hollywood provides a really messed up view of what a good teacher *should* be. If you aren't poor, spending all of your own money on the kids, and working to the point of neglecting your personal relationships, you aren't a great teacher.

I worked for YEARS in an inner-city school, and people met me with some combination of awe and worship for it. I worked myself to the point of panic attacks and depression, to the point where I would not stand up against the regulation of not taking a personal day during the first 10-days of school and did not go to the hospital with my husband when he had a catheter ablation...because I'd told him the "rule" and he'd ignored it. Do you see how maybe I got to the space I was in with my M?

So, now I live in a different state teaching kids who aren't in such dire situations. I teach kids in a whole range of needs, from kids who are developing substance abuse problems, to kids who just need me to help them find out they *can* be successful, to a lot of my gifted, well-off kids who are under such pressure that a B on a progress report leaves them sobbing on the bathroom floor. In 8th grade. My kids now aren't *as* needy as my kids before who were dealing with extreme poverty and unsafe conditions, gangs, and crime, but they still need the service I provide.

Does it make me a less valuable teacher now that I'm in a fairly good school with more "normal" and less life-threatening issues?

Am I a bad teacher now because I set boundaries around when I leave everyday and refuse to take work home at night?

Is it wrong to place my personal well-being above my job?

I don't think so. I think I am providing a valuable service to the kids and parents in front of me. I think they have need of me to the same degree that my other kids did, just in different ways. I ALSO think I have become a FAR better teacher since I have put taking care of myself and my R above my job--which I love and have an unrelenting passion for.

So, don't you dare put whatever you're doing in the next part of your life into some sort of less-than box. Might you prefer one to the other? Sure; I loved my inner city babies passionately...and it kills me that the system is set up to fail them. But I love the kids I have now as well...and this job, with its DIFFERENT challenges, opportunities, and experiences.

Sorry if I've come off kind of strong...it's just that this particular conversation has been coming up again and again in my life (especially with our newer teachers who beat themselves up because they're not working 24/7 and dare to leave at 7:30 at night), and it's something that gets me all fired up. And, probably, something of which I need to remind myself.

Congratulations on your new position! I wish you joy.

SD

SD..that was a great response and I'm sure you know how important teachers are and how I remember each and everyone I had.

The change that will have to be revealed to my STBXW will be startling. She may not give a hoot...or may put it on the pile of character flaws that she believes I have (like vile and disgusting)...but I doubt she will care one way or another. The relationship we now have is cold...functional...minimally cordial...amazing to think that we were husband and wife once. Yesterday, she hit me up for $24 to cover the kids doctor copays. Although I AM responsible for that, it seems pretty petty.

I'll ask her to give me the receipts.

FIB

FIB, congrats - well done. The new job does not take away all the wonderful things you did for 23 years. You made a difference in this world.

So, now FIB, take a breath, remember who you are. You will still be a doctor, helping people in their lives. And now you will have the time to volunteer somewhere if you choose to. You will be able to spend more time with your children and have a real life. Nothing wrong with that.

You gave so much, for so long. Now its time to take back a little. FIB, be happy, its going to be ok.

As far as your w, dont worry about what she thinks of it all. Dont let her tarnish the decision. Remember why you made it!

COngrats FIB!!!!

you will be amazing at whatever job you do...

amazing people are like that

OK...the job will be in Manhattan..in the private sector..performing a legitimate type of cosmetic surgery. It requires 3 months of training, but, I heard last week that they are going to try and help me. I can do one month in Manhattan and 2 in CA instead of 3. I WILL be operating but doing a minor procedure repetitively requiring an artistic approach. I will still be an MD...still be a surgeon..still be boarded and a Fellow of the American College of Surgeons...but will be restricting myself to one cosmetic procedure type.

Minuses:

• will have to commute into Manhattan, getting up very early M-F and become a 'straphanger'; will have to put in a full Saturday 1-2X per month
• will lose free time during the day...i.e., running home, running errands, doing odd things, etc
• will give up being a general surgeon, taking care of sick people...the real reason I went into this...altruism
• will lose variety of taking care of different medical illnesses..lose my skills of operating on major organ systems...lose my skills of diagnosis and physiology (meaning, lack of use, not surrendering them per se)
• will burn my bridges as, once I make this change, it would be nearly impossible to go back
• the impression to others that I couldn't do it...couldn't make it...gave up.....etc
• loss of status
• potential boredom/monotony of doing a minor case over and over

Plusses:

• no more emergencies or emergency room call..will not get called away from my family during the night or on weekends
• much less stress
• potential to take home a much greater income
• more availability to my children...stronger presence for 'custody' issues
• status could be either higher (Park Avenue 'nip and tuck') or lower (gave up his general surgery to do 'this')
• higher income will allow me to get out of debt and better support my children (er...my W will get a piece of this but she would get a piece of WHATEVER I do now)
• no more problems paying salary, overhead, payroll, etc
• lower malpractice premium...less litiginy
• change

I've thought about this since my first interview. Factors affecting my choice:

1. since my STBXW lives in NY, I will NOT be able to live far from my children, limiting me to NY
2. the private practice of general surgery is dying here, and, you can't just pick up and move to another town and do better
3. if I leave the state to make a better living, I lose my children
4. I prefer to stay within SOME medical field doing SOMETHING with my hands. I think I'd croak if I had to become a pharm rep or something like that
5. I have a big birthday next year. In order to maintain income, I've had to increase the number of ER calls each month to get work. More ER call = less available time = more late night calls = increased exposure to law suits = exhaustion both physical and emotional = kids crying "daddy, why do you have to leave me". Forward thinking...asks....how long can I do this now that I am this age and in this divorce predicament?
   
   So, here I am....
   
   FIB

FIB--

I don't know why I didn't think of this before or even if it will help, but my BIL's girlfriend made a similar change when they moved out here to CA. She worked as a surgical nurse at Johns Hopkins in Baltimore, mostly in neurological cases. She loved it and found it challenging and fascinating. What she didn't love was the impact on her "real life"--holidays, time available for her boyfriend, etc. So, when she moved out here (and was in high demand, really could choose whatever position she wanted), she ultimately chose to work at a surgical center doing a lot of repetitive, less challenging surgeries. She's a full year in now, and while she misses the challenge, she loves the regular schedule, the pay, and being able to have a normal personal life.

Don't know if that helps much, but I wanted to pass that along.

SD

WOOOOOOOHOOOOOO... Congrats on the job!

Everything is a tradeoff. More time to make a life with your kids, defined income, letting someone else worry about the business decisions ??????? HMMMMM????? AH no brainer. This should help your anxiety level don't you think? So in the longrun it all works towards making your life and your childrens' lives a lot happier.

Bethie

Congratulations, FIB!

I don't know the exact nature of this procedure, but is it possible that - in addition to doing it for regular patients - you could spend some time doing it for patients who are not having it done for purely cosmetic reasons? Again, I don't know what it is (nor do you have to say), but it's a thought...

And thanks for the cabana boy picture - it made me smile!

Excellent on the job!

Luck with it - you will do well.

I will not say what it is - but I will tell the ladies here it is NOT boob jobs or anything related

Although, for guys in our situation ....

Enough said.

Few get to start new careers at the half-century point. Stand proud.

I WILL be interested at your W's reaction.

Until then, ace the training and learn how to read a newpaper while clutching a strap on the train.

Strength and Honor.