Take a hike

Last summer, in the throes of pandemic angst, I asked my good friend (an endocrinologist who radiates calm, love and compassion) how she was keeping her sanity and balance. Her answer astonished me because it was unexpected – I always pictured her as more of a town mouse rather than a country mouse, like myself.

“We’ve been hiking!” Every weekend, she and her family had been exploring the great outdoors as long as the weather cooperated. She excitedly told me of exploring Ohiopyle and various state parks with her family and bubblemates, and of the profound peace and joy it had brought her.

“Isn’t it hard?” I asked. I had always pictured hiking and camping as something Other People Did. After all, there are bugs, creeks, mud, uneven ground, wild animals and ticks to be reckoned with, as well as a conspicuous lack of indoor plumbing. And bears. Let’s not forget about the bears.

“Not as much as you would think. There are easy trails, and then when you get your confidence up you go for just a little bit more. It’s worth it – the woods and the views are so beautiful! So beautiful that you forget about everything else.”

That’s the key. As physicians, we need some outlet or activity that allows us to forget about everything for a few hours. For some, this might be yoga; for others, driving racecars at 125 mph on the hairpin turns of a racetrack. For some, it is the release of a physical sport like running or tennis or skiing, for others, a more cerebral occupation like chess or bridge or writing. One classmate from medical school is writing a professional comic strip to take him away from the cares of the ICU; another has become an extraordinarily good wildlife photographer. Still others play golf, or go fishing. Travel is another cherished outlet.

My generation was asked – nay, required – by college and medical school advisers to identify our “passion” and to have several respectable hobbies suitable for discussion in application essays. In truth, most of us didn’t have time for passions and hobbies while applying for medical school, residencies and fellowship. “But my passion is excellence in everything I do! My passion is patient care!” These were not acceptable answers from a trainee for some reason, although ironically these are highly desirable answers from attendings. I’m hoping advising has changed.

“Passions and hobbies” are mostly good to have as a student in order to round out your CV, mention in your personal statement to make you look relatable and human, and to make decent small talk with interviewers. Our time then belonged to our studies, our work and our family. Passions and hobbies were mostly things we enjoyed in our free time before we decided to enter the field, and polished up because our advisers told us we needed something to distinguish ourselves socially from other candidates. Some people are lucky – they truly do have passions that claim them from an early age – maybe they got an early taste for distance running or mountain climbing or surfing or patisserie or the violin, and now are focused on marathons and ascending peaks and shooting the curl and making exquisite confections and playing concertos all over the world. More power to them. What struck me as a medical student was how all of these desirable “passions” one was expected to have required money or connections, neither of which the average college or medical student enjoys. The message I received: Passions require privilege. Privilege requires money. But the best things in life are free!

Well – as an attending, you don’t need a passion that you can blather on about at cocktail parties (face it, no one wants to hear you brag), and you don’t need a hobby to define you. Life is not an application essay. Ostensibly, your true passion is medicine; otherwise, you would not have committed the entirety of your precious youth to study and training and would not be working in the field now. Many years ago, I asked a long-married older local MD about his hobbies many years ago, and his reply remains indelible. “My wife is my hobby,” he said, which made his wife beam. What you *need* are multiple interests outside of medicine and family which make you happy, reliably put a smile on your face. These interests must get you off the couch and out of your head, and into the company of people you enjoy.

When work falls apart, there’s family to support you. When family falls apart, there’s work to support you. But what if both fall apart – what then? At some point, you may choose to retire or be forced to retire by forces beyond your control (health, family, politics, etc). If you have children, at some point you will become an empty nester. No one tells you in medical school to avoid the trap of letting medicine become your primary identity. And if Spouse or Parent is your primary identity, and your spouse leaves you by death or divorce, or your children move halfway across the world, or both, what then?

You need good friends – some your age, and ideally some younger in order to keep your mindset young. (Pediatric specialists are legendary for never truly growing up inside – how can you, when you are surrounded by the infectious energy of giggling kids?) And after we exit the educational milieu, the best way to make new friends as an adult is through shared interests or activities. People who meet in the context of trying to forget about the rest of the world are going to show each other the best of themselves, so it’s likely to be a pleasant interaction. Gleaning true friends from mere pleasant acquaintances is the logical next step, over time and through repeated interactions.

The Harvard Study on Adult Development – the longest study on happiness – showed that happiness is most dependent on having strong personal connections, good relationships and emotional support – whether from spouse, family, friends, or social circle. It also showed that as we age, happiness is best found by letting go of past failures, and focusing on simple activities that bring you joy and connection and that can make you happy in the present.

So, get out there – find joy in the simple things, surround yourself with beauty, enjoy old friends and make new ones, and find something that can reliably take your mind off the rest of your life. If you’re looking for ideas on how to get started, call a friend or loved one and go for a walk in the park on a beautiful summer’s morning – or better yet, take a hike.