Medicine, Identity, and Your Future Self: The Physician's Dilemma | Ep15

Michael Hersh, MD

[00:00:00] What if your future self could talk to you right now? What would they say? Maybe it's time to find out. Stick around because that conversation might just change how you see everything.

Welcome back to Better Physician Life, and thank you so much for being here with me today. Now, I'll be honest, what we are talking about today might sound a little woo or a little out there at first. I totally get it, and I probably would've rolled my eyes a few years ago too if someone asked me to picture my future self.

Hang in with me because this isn't about vision boards or some fantasy version of yourself sipping margaritas on a beach at 65. This is about the real person you are becoming, the older you, the version that exists 10, 20, or maybe even 30 years down the road. The one who's going to live with the [00:01:00] choices you are making right now.

The one who's gonna remember whether you kept blowing off your health, whether you made it home in time for dinner, whether you pushed through another shift, instead of just saying, no, that's your future self, and someday he or she is gonna look back at you, the version sitting here right now, and either thank you for how you handled things and set them up for success.

Or shake their head and wish you'd set them on a better path. For me, the first time I even thought about who I might become goes all the way back to middle school. We had one of those career research projects. You probably did the same thing. And at that point in my life, I just walked into the library, pulled a book off the shelf, and there it was, the roadmap.

College, medical school residency, fellowship. I didn't know what [00:02:00] half the words meant, but I knew one very important thing. I wanted to be a doctor, so I started planning and from that point on, it was a checklist. High school, MCATs, medical school, residency, fellowship, practice, step after step box after box.

Each step lined up, each milestone reached and so many of us, I figured that was enough. Because in medicine we are trained to believe the work is the identity, the badge, the coat, the title, the role. That's who you are. The dependable one, the one who pushes through, the one who keeps going, provides and achieves.

What I didn't realize until much later was this, while I was busy planning my career, I forgot to start planning [00:03:00] my life. And maybe you felt that too. Maybe you've realized somewhere along the way that you know exactly what you do, but you're not entirely sure about who you are. The first time someone asked me to picture my future self I thought it was a little ridiculous.

They asked me, who will you be 20 years from now? What will you care about? What will you be proud of? And my mind was just blank. Half the time I can't even decide what I want for dinner. How in the world am I supposed to know who I want to be in two decades? But the longer I sat with that question.

The more uncomfortable it became because I realized I'd just been following the map. I was given step after step. Yes. After, yes. Never asking if it was taking me where I actually wanted to go. So let [00:04:00] me ask you this. If your future self could talk to you right now, what would they say? Would they thank you for finally getting serious about your health and exercising more?

Would they wish you hadn't ignored that blood pressure you've been brushing off? Would they respect how you kept saying yes at work or would they regret how many dinners you missed? Would they admire the way you toughed it out and wish, or would they wish you had the guts to stop numbing with alcohol or Netflix or mindless doom scrolling on social media and just face what was really going on?

There's no judgment here. We all do this from time to time and that includes me. There was a stretch when my evenings were just collapsing onto the couch, zoning out in front of the TV or doom scrolling on my phone until I couldn't keep my eyes [00:05:00] open. It wasn't about the show or what I was seeing in my Facebook feed.

It was about not wanting to deal with what was underneath. It was about trying to avoid the dread of going to work the next day. It was about avoiding the discomfort in my life, and for a while it worked until it didn't. But wait, there's more. I stopped going to the gym for five years, skipped physicals, blew off blood work, ate bad food because I was exhausted and starving and deserved it.

I slept five hours a night, week after week, and wore it like it was a badge of honor. If one of my patients told me that this was their life, I would easily counsel them. This isn't sustainable, but for myself. I called it grit and dedication, but in reality it was neglect and the cost wasn't just physical it showed up in my [00:06:00] relationships too.

Conversations with my wife sounded more like a logistics company than a loving, caring relationship. Kids bills, schedules, all the while I told myself I was doing it for them, for the family. The truth is they didn't just want the paycheck I was bringing home. They wanted me, and I wasn't giving them that, and friendships forget it.

Somewhere along the way, I convinced myself I didn't need to continue cultivating friendships, that guys my age didn't really hang out anymore, that I was too busy, too tired, and slowly without realizing it. I stopped having people I could really talk to. I was surrounded by colleagues all day, but I was alone.

We don't talk about this stuff in medicine, the real stuff. Sure. We'll talk about the latest EMR upgrade that everyone [00:07:00] hates, or our latest vacation or the weather we might mention our kids chat about our tough cases or complain about the administration. We don't talk about laying awake at 3:00 AM, staring at the ceiling, wondering if this is really the life we wanted.

We don't talk about the fear of being irrelevant if we ever stepped away from medicine. We don't talk about how fragile it all feels when our whole identity rests on the work we do. But here's the thing, your future self sees all of it. The real truth, he or she knows if the story you are writing is one you'll be proud of or one you'll regret.

I'll never forget a conversation with a senior colleague who was close to retirement. He is one of those guys. Everyone looks up to well-respected and accomplished the kind of career [00:08:00] people point to as an example of how to do it. And I asked him what he'd do differently. And without missing a beat, he said, I thought I'd have more time, but I didn't.

And that one sentence gutted me because I knew exactly what he meant. We all do, and it hit me again. The night I missed my daughter's band concert, I had the date blocked. I was supposed to be there, and then they changed the date. My schedule was booked and it was too last-minute to change, so I worked because that's the job, that's what we do.

But when I came home that night and saw the program on the counter it landed differently. The patients needed me in that moment. Yes, but so did my daughter and my future self isn't gonna forget which one I missed. And that's the trap, isn't it? [00:09:00] The job always feels urgent. Everything else feels optional, but your future self knows the truth.

The hospital will replace you in a week, your family won't. So maybe the better question isn't what do I need to do next? But what will my future self thank me for? Maybe they'll thank you for actually taking that vacation. Maybe they'll Thank you for finally making your own doctor's appointment. The one you've been too busy to schedule for the last five years.

Maybe they'll Thank you for skipping that extra shift and actually showing up at the soccer game or for calling a friend you haven't talked to in forever. Just to catch up. Maybe they'll thank you for realizing you were stuck. For doing something about it instead of just grinding it out, because that's another thing, we don't talk [00:10:00] about being stuck, feeling like you're out of options, wondering if you've hit the ceiling of what this career has to offer.

It's easy to assume. Being stuck means you're failing, but it doesn't. Being stuck is feedback. It's information. It's your life telling you something has to change, and if you listen to it, it could be the very best thing that has ever happened to you. I've hit walls, I've kept grinding. Long after I should have stopped.

I've ignored the warning signs, but I've also learned that feeling stuck doesn't mean I'm broken. It means I've got a choice I can keep ignoring it. Or I can use it to motivate myself to do something different. So if you are in that place right now, here's what I want you to remember. Your EMR won't remember you.[00:11:00] 

Your RVUs won't keep you company. The hospital will move on. But your future self, the older version of you, 20 years in the future, he will remember. He'll remember the small choices you made, the times you actually showed up, the moments you protected what mattered. Instead of letting it slide, the times you lived, like your health, your marriage, your friendships, and your joy were worth it.

And when that time comes, the only question will be, will he thank you or will he wish you'd done it differently? Over the years through my own mistakes and through listening to colleagues, I've learned a few truths. No change is too small. Even leaving on time once can shift how you feel about your life.

You're allowed to want more than work. Medicine can be [00:12:00] central, but it doesn't have to be the whole story. Rest is not weakness. It is fuel. Protecting your health isn't selfish. It's survival, and there's no single right path. And last, asking for help doesn't mean you can't handle it. It means you're wise enough to know you don't have to do it alone.

So if you take one thing from this, let it be this. The best way to predict your future is to create it. Not with some grand reinvention, not by muscling through one more call night, but with small deliberate choices you get to make every single day. And if you are ready to think about that a little more, I put together a worksheet called Design Your Life, A Goal Setting Guide for Physicians.

It's a practical [00:13:00] way of stepping back and asking yourself what you really want your life to look like 5, 10, 15, even 25 years from now. Because you can't create that life in 25 years if you're not planning for it today. It'll guide you through some honest questions about your health, your relationships, your time, your career, and what really matters outside of the job.

The parts of you that can get lost when medicine takes up all the space, and you can grab it for free at betterphysicianlife.com/design-your-life, and I'll make sure to have the link in the show notes. You can check it out there. So let me ask you again. What would your future self say to you right now, that older, wiser, grayer version of you, and what would it look like if you actually [00:14:00] listened?

Because your life is bigger than your career, and when your future self looks back, the question is simple. What story will he or she tell about the person you chose to be? Thank you so much for spending this time with me. Take good care of yourself and remember your future self is already rooting for you.

I'll see you next time on the Better Physician Life Podcast. Take care.