I am bad at taking vacations — really bad.

It’s not that I don’t take days off or even travel on days off. It’s my near inability to actually unplug and not bring work with me. Despite recovering from a level of burnout a few years ago that left me considering quitting medicine altogether, I still struggle with this.

There is a never-ending to-do list related to work — both the items I really want to do and am excited for, contrasted with the mundane tasks I dread. It is so easy to feel that a little work on those off days will allow me to catch up, to not feel so far behind when I return and relieve the stress that comes from taking a vacation.

This is crazy, right?

I know the science behind burnout. I know the profound value of days off, mental rest. The result of a well-taken vacation or time off of work is rejuvenation, increased clarity and productivity upon return. Vacation makes you better. Sharper. Self-care is critical to continued high performance. Yet, I still struggle to let go. Somehow, I think continuing to work will carve me into a true master of my craft.

A few weeks ago, I unplugged for several glorious days in Napa Valley with my husband. We drank the wine. We ate the food and allowed ourselves to relax. We rose before the sun on a Saturday morning for a hot air balloon ride over Napa Valley — a bucket list item for me.
While we enjoyed coffee and pastries awaiting our time to board the balloon, we learned that we would have to relocate due to fog. An hour later, we exited out the van to watch several hot air balloons rise over the countryside, floating away from us, while our pilots felt the winds were too strong, too unpredictable and decided we would not fly. Disappointment does not even cover the emotions I felt as yet another attempt at riding in a hot air balloon floated away on the California breezes.

One of the two pilots who refused to fly apologized and said, “I’d rather disappoint you and not get paid today than fly if I do not think it is safe.” We re-entered our van and rode back another hour in silence.

Two mornings later, we tried again. This time, the weather was favorable, and we watched the flames filling the hot air balloons in Napa Valley. We entered our oversized wicker baskets and rose with the sun, over the patchwork fields of vines. The pilot was, again, one of the two who opted to disappoint us all on that Saturday morning. As we flew, he told us stories of flying balloons, of how landing becomes a challenge if fuel is running low and the balloon does not lower as expected. The good, the bad and the ugly of a career as a hot air balloon pilot.

We attempted to land several times, but the wind pushed us out of our target areas. We were going to need to land in a private vineyard. In Napa, if you destroy a vine with grapes, you must replace the vine and the costs for five years until the grapes are in production again. The cost is great. We floated down toward the vines and could see the grapes, practically touch the vines as our fuel dwindled and our pilot searched for a landing spot. On a small dirt road, flanked on either side by mature grapevines ready for harvest and with a large oak tree marking the end of the road and vineyard, our pilot dropped the balloon to the ground gently with profound skill. Not a grape fell. The balloon was brought down without a puncture from the tree or vines. Quiet expertise — a true master of his craft.

How do you remain sharp? A master of your craft?

There are days you do not fly — those you rest and those in which the conditions are not favorable enough for certain tasks. As an MD this includes days off for vacation and days you should not work, such as when you are sick. There are days you disappoint others because you did not meet their expectations. As a physician and parent, there are choices that are unpopular despite being the safest choice. A master of their craft is not simply an expert; they are a master because they inherently know when they are set for success and when they are reaching their limits. There may be times where conditions are out of our control, yet we can choose how we set our course, whether sails or balloon.

Too often we fall victim to the guilt of needing to be the constant expert, the ever-working example and then fall short of being a true master of our craft.

Take a vacation, take time each day to truly rest. Cultivate the master within you that can balance expertise with limitations.

Kelly Cawcutt is an infectious disease physician and can be reached on Twitter @KellyCawcuttMD.

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