I remember medical school orientation clearly. I was excited, nervous, confident, and full of self-doubt, all of it wrapped up in a kind of nervous energy. I had a clear vision of what my life would look like. I would finish medical school, complete residency, and practice primary care back in my hometown. The white coat they draped over me at the ceremony did not sit comfortably on my shoulders, and I am sure I looked like a kid playing medical student to the first patients whose rooms I walked into.
I am now closer to retirement than I am to that orientation day. The life I have lived looks very different from the one I imagined. And yet, underneath the surface, the resemblance holds. I still live within driving distance of most of my family. I chose pediatric cardiology instead of primary care, but the reasons I wanted primary care in my hometown, relationships with patients and colleagues that stretch across decades, the feeling of being rooted in a community, the privilege of knowing someone’s story, turned out to be the real vision all along. The specialty changed. The story underneath it held.
As I think ahead to retirement, I have an idea of what I hope my legacy will be. That I cared. That I showed up even when it was hard. That I was creative and good at solving problems. There was a time in my career when the path was far less clear, when I thought about walking away. I can sit now at a point where I can honor the story my younger self imagined, look honestly at the story I have already written, and see the shape of the one I want to build in the decades ahead.
I have talked with a lot of physicians who cannot say the same. They are stuck, angry, uncertain of what comes next. Some believe their only option is to stick it out and be miserable. Others are ready to blow up their lives. Many sit somewhere in between, unable to name what they want at all. I think part of the reason these feelings run so strong is that three stories press on us at once: the one we told ourselves when we started medical school, the reality of the one we are living, and the uncertainty of the one we will leave behind. The distance between them weighs more than any single bad day.
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Knowing your role
In health care, it is easy to cast everyone around us in roles. The system plays the villain. The administrator plays the villain, too, or perhaps a colleague plays the jester. There is probably some truth to how those characters fit their parts. But the casting of others was never your job. Your job is to know what your role is, control what you can, and write your own story.
Some of my favorite characters in books are the guides. Gandalf in “The Lord of the Rings.” Dumbledore in “Harry Potter.” Moiraine and Lan in “The Wheel of Time.” Even in the books that give you the guide’s point of view, where you learn their history and their burdens, the story ultimately belongs to the hero. The guide walks beside the road. The hero walks it.
Physicians are taught to be guides, and clinically, that is what we are. We offer suggestions. We prescribe treatments. But in the end we are guiding patients toward their outcomes, and it is up to them to be the heroes of their own lives. That framing is easy to accept for our patients and strangely hard to accept for ourselves. Because the same rule applies: it is up to us to be the heroes of our own lives. If guide is the only identity you hold, that may be exactly where the mismatch lives. You can spend an entire career standing beside other people’s roads and never once ask where your own is going.
The honest answer
In coaching conversations, physicians work through exercises that can look deceptively simple from the outside. What matters to you. What your innate strengths are. How you communicate. And sometimes people ask, fairly, what the point of all this is. Two things surprise them. The first is how hard the questions are to answer. The second is how long it has been since anyone asked.
The honest answer to “what is the point” is this: to reclaim your story. To become the hero of your own life and your own career. To recognize and honor the roles you play in other people’s stories, the guide, the jester, the parent, the colleague, and to remember that playing those roles for others never required you to give up the lead in your own.
The system will keep writing its version of your story for as long as you let it, and it will never once ask what you wanted the story to be. Somewhere there is a version of you standing at orientation, coat too big, certain of a future that will not arrive the way they picture it. You cannot go back and correct their predictions. You can still honor what they were reaching for. The pen is yours. It always was.
Ben Reinking is a board-certified pediatric cardiologist, medical educator, and certified physician development coach, as well as the owner of The Developing Doctor. He can also be reached on Instagram.
He’s not just any coach—he’s a practicing physician who truly understands the realities of modern medicine. He knows firsthand the internal battles you’re facing, from short-staffing and limited resources to production metrics, constant billing pressures, and the ways your altruism can be taken advantage of. Ben is here to help you reignite the passion that first led you to medicine and provide you with the strategies needed to regain control.
