Louisville Medicine Volume 63, Issue 9 - Page 16

MEDICINE AND THE UNEXPECTED: A LIFE AND CAREER WITHOUT PLAN B Scott Duncan, MD, MHA, FAAP I n the throes of my youth and adolescence, I thought altruistically. I always wanted to become a doctor. I considered being a missionary and treating the poor, and becoming a heart surgeon. I learned to be concerned for the welfare of others. I didn’t have a Plan B. My father suggested that I join the military to pay for my college degree; I politely declined. He suggested I stay home; I politely declined. He suggested a large state–run institution; again, I politely declined. I learned the advantage of personal attention and the joys of a cadre of close friends at a small liberal arts university. There wasn’t a Plan B. 14 learned how to be students and survivors. We didn’t have a Plan B. After completing two years of basic sciences, I still had no career plans and remained unfocused. During my junior clerkship in Pediatrics, I spent two weeks in the Neonatal Intensive Care Unit with a professor passionate about his work. I learned about clarity and a life’s calling. I didn’t have a Plan B. After residency, I completed a neonatology fellowship. But my altruism had been shaken. I saw infants struggle to survive. I became leery of the high-tech solutions at our disposal to prolong life. I was disillusioned as a researcher. I needed a break from academic medicine. I learned that a change of scenery often lends perspective. I didn’t have a Plan B. Before entering medical school, everyone asked, “What are you going to do?” “What specialty are you going to choose?” I replied, “I could never do Pediatrics,” but I really didn’t know what I was going to do. I learned that uncertainty wasn’t a bad thing. I didn’t have a Plan B. Fresh from training, I soon recognized that my first position wasn’t going to work long-term. I lined up a job near my hometown and moved. I learned you can go home, but it’s never quite the same as you remember it. There wasn’t a Plan B. Many of my classmates and I found the transition from college to medical school as a shock to the system. We struggled that first semester. I found myself on the verge of failing coursework. We The one