The Unconventional Life

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A recent New Yorker article summarized the three stages of the American immigrant experience: First Generation: work hardscrabble jobs, sacrifice for children’s education Second Generation: academic achievers pursue professional careers in medicine, law, finance Third Generation: take Improv classes I found this a concise way of capturing the internal tensions we all struggle with to some degree:  on the one …

Top 10 Reasons I Always Travel Carry-on

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Checked bag fees and lines are for suckers. Secret to eternal youth: less stress + less back pain = greater stamina. Missed connections / delays will never deprive you of clean underwear. Join a secret society: carry on travelers share a self-sufficiency gene that is the key to evolution. I’m a control freak. Keeping my bag in reach is one …

All I Really Need to Know I Learned from Rick Steves

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I was one lucky son of a gun: 22 years old, graduating college, accepted to medical school.  I had an airline ticket (thank you, generous aunt and uncle), a Eurorail pass (thank you, savings from college gig as a Sunday school teacher), and a ginormous new Eagle Creek backpack bought on sale (if only I’d known that used is the …

Cultivating Gratitude

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The key to living well is living not just within, but comfortably beneath your means.  This means cultivating habits that will reward you in the future.  One key habit is to adopt a perspective that allows you to appreciate how good your life is right now.   While it has always been fashionable (if tiring) to whine about low resident …

What Is Pleasure Out Of Proportion?

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In medical school we studied necrotizing fasciitis, colloquially dubbed “flesh-eating bacteria” in the lay press.  One of the hallmarks in distinguishing this disease from less aggressive soft tissue infections is pain out of proportion to physical exam findings.    I’d come to remember this concept decades later, as I began to develop a reciprocal theory: pleasure out of proportion.  (Decontextualized, …

Cultivating Growth Mindset

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Freshman year at Stanford had been a humbling experience.  Everyone around me, it seemed, was smarter, more experienced, more accomplished than I was.  Shawn Green was a personable guy in my dorm – and the only frosh I knew getting a $725,000 signing bonus as a first-round draft pick for the Toronto Blue Jays.  Our dorm also claimed the new  …

Adapt Your Medical Career To Your Life Needs

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I had just turned 40, and was leading a busy life that might resonate with your own: a full-time job in community practice, marriage and fatherhood.  Since I didn’t want to take time away from my wife or kids, self-replenishing (i.e., pleasure out of proportion) pursuits suffered.  A writing group I’d started in internship began to founder because the handful …

Top 10 Life Hacks I Wish I’d Cultivated In Training

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You’re a busy person, you want only the essentials: what can you do today (as a med student or resident) to make your life better tomorrow?  Following is a basic tool kit with immediately actionable items, to be elaborated in later posts. Reduce expenses. Optimize housing, transportation and food.  Dine in. Buy staples in bulk.  Brew your own coffee. Get …

Does The Future Frighten You?

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Last night, in a mood of playful optimism, I asked my wife what she thought the next decade might bring our way.  She remained elusive, and qualified her non-answer with her own version of of the spit-over-your-shoulder superstitions that my grandmother (who believed in witches) might have engaged in when I was a child. I tried to explore the source …

Breaking Up With My Financial Advisor

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Financial Ignorance, The Great Equalizer (3 Of 3)Ignorance Becomes UnaffordableFast forward a decade.  After my physician group institutes some changes that significantly improve our collective lifestyles, my work-life balance is restored and I am reading voraciously once again.  In February 2016, an article in The New Yorker profiles Mr. Money Mustache.  He and his wife, both software engineers, spent 10 …