Can Skills Used To Build Wealth Also Build A Life?

Have I Lost The X Factor?

A favorite WCI post describes the X factor, a perfect storm of innate qualities, experience and self-discipline that lead to wealth-building behavior. Those who possess it often have certain traits in common, which may include:

• Laser focus on goals.
• Ability to sacrifice and delay gratification translating to the ability to save aggressively.
• Reaction to negative experiences (being financially exploited, insecurity from childhood poverty).
• Ability to independently develop financial literacy and cultivate positive financial habits.

The X factor, as described by WCI, is an internal drive that you either possess or you don't.

And Now For Something Completely Different

Digression break: At one of my interviews for residency, I was asked by an incisive and pleasant faculty interviewer to describe a hobby I enjoyed and link it to traits that might contribute to my candidacy as a future emergency physician. My selection? Bird watching.

I explained that as a bird watcher you have a brief window of time to quickly assess a situation working on incomplete information. You use available diagnostic clues (relative size, flight pattern, markings, color, geography, time of year) to generate a differential diagnosis and deduce the likely species you've spotted.

The subjects of interest often depart before your analysis is complete, and they can be flighty (see what I did there!). You routinely witness bizarre extremes of unusual behavior, renewing your sense of wonder at the vast tapestry of the natural world.

Take the description above, substitute the phrase "weird things that people insert in their rectums," into the final sentence, and you've got emergency medicine.

Now let's turn the binoculars around and investigate the characteristics of your typical bird watcher.

He's a bit eccentric. His knowledge base is wide of necessity, and while he is most familiar with the typical birds of his region he also cultivates an awareness of rare exotic visitors that are not statistically common but are vital to detect when they visit.

He is compulsive about discerning details, systematic in appraising new subjects, and learns to size up his subjects during extremely brief but critical periods of contact.

If you suspect these traits might easily describe emergency physicians you work with, you may be onto something.

A Pathology With Utility

Medicine is full of habitual overachievers. We exhibit variations of the X factor, and we apply it relentlessly to our studies. We would not have made it into medical school without it.

I favor the term pathology with utility - the particular brand of crazy that imbues you with superpowers when it emerges under the right circumstances.

I was deeply motivated as a high schooler with a boatload of extracurricular commitments, class leadership positions, club presidencies, hospital volunteer work (in the 1980s an adolescent male volunteer was an anomaly among mostly blue-haired retired ladies, unlike today), a job teaching Sunday School, participation in multiple singing groups, and roles in school musical productions (I won the Best Dancer award for balancing a bottle on my head in Fiddler on the Roof; I had a small solo, and you'd better believe I sang my heart out).

 I was deeply motivated as an undergraduate at Stanford, winning a competitive undergraduate research award for work I'd sought out in the lab of a professor at the medical school, earning a now higher salary teaching Sunday School, joining the lacrosse team to learn a sport I'd not heard of until college, and earning a degree "conferred with honors and with distinction."

I remained deeply motivated as a medical student at UCSF, a resident at UCLA and during fellowship at Harvard.

I was going to be an academic. My stock was rising in value. My mentors suggested it would be a simple matter of time before I joined their ranks in the ivory towers, and I desperately wanted to please them and fulfill the promise they saw in me.

Something Happened On The Way To Chasing The Shiny Brass Ring

I became disillusioned with academics when I observed it up close, and I quickly learned that my particular pathology might not thrive in an academic environment. I was able to do the work, but it did not bring me the rewards I'd thought it would.

As I developed a clearer picture of what my ideal life outside of medicine looked like, I realized it was not compatible with an academic career. When I met the right girl (also an aspiring academic), we both realized we were in the wrong jobs to support our shared vision of a future together.

It also dawned on us that becoming accomplished academic junior faculty had unwittingly extinguished other facets of our personas that brought us satisfaction. We resolved to revive those neglected passions, and resorted to a radical relocation to reinvent our lives beyond the hospital.

We traded Boston academic appointments for community practice jobs in coastal California, rented a dusty apartment within walking distance to the beach, and started a family.

We bought one another used wetsuits from a scraggly bearded sidewalk vendor who kept his inventory in an old VW van. He shook my hand and introduced himself as "Surf Rat."

Shakespearian Aside

I typed these words having returned from a three week trip with family where I did not shave, and I could well be mistaken for Surf Rat given my current choice of attire and unkempt manscaping.

The Shiny Brass Ring I'm Pursuing Today Isn't On The Menu

I don't fit the traditional parts in the existing scripts of medicine. In fact, I'm suspicious that those scripts fit many of us who end up acting out the roles anyway.

My time these days is filled with connection, community and interesting tangents. Here's what my September calendar looks like:

• Heading an interdisciplinary group at the hospital looking to curtail the cost of ED super-users by allocating greater resources and increasing their access to care.
• Learning how med-tech companies function by attending an invite-only company summit to see if what they do might be an interesting new way of using my brain.
• Hosting childhood friends on their visit from South America.
• Reading! Deep Work by Cal Newport, SEO for Dummies, and Ron Chernow's biography of Alexander Hamilton.
• Celebrating 13 years of marriage to the only superwoman with the resolve to put up with me.
• A visit to my parents and extended family in my hometown.
• Hosting a champagne toast for 35 people before we walked our sixth grade daughters to their first ever junior high dance!
• A full moon hike at a local parkland reserve.
• Meeting out of state friends we'd not seen in years to catch up during their brief visit for a conference.
• Reading the final Lord of the Rings book (along with one of the rare Far Side collections that had eluded us) aloud with my son.

What about medicine? It's is a remunerative hobby that remains enjoyable because I do less of it. Have I not gotten killed on recent shifts and felt the pain? Absolutely.

How do I cope and recover? Ideally my shifts are spread out, although that was not the case this month. If I get to fill my time with the activities above, by the time my next shift rolls around, I feel fresh and ready for combat.

Have I Lost The X Factor?

Maybe I haven't lost the motivation of my overachiever years so much as channeled it in new ways, applying my innate pathology to a previously untapped utility.

Might I have altered WCI's original definition of the X factor into something more touchy-feelie, taking skills he used to build wealth and his business and using them to build a life? When he wrote the article it struck me as exalting entrepreneurs. Many of the skills still resonate:

• I remain laser focused on spending my time in accordance with my values, and being present for my wife and kids while the latter are receptive to my company. I'm quick to decline commitments that come at their expense.
• I am willing to sacrifice income to retain control over my time, often paying dearly for the privilege.
• My reaction to a negative experience (burnout) helped inspire me to redefine my job by initiating group policy changes, making it sustainable.
• I am continuing my financial literacy education by consuming blogs, books and ideas written by those smarter than me.