Leaving your career in medicine is like breaking up in a long term relationship. It may have all started out with lofty expectations, excitement about the future, and becoming your best self. However, somewhere along the way, things got messy and twisted and not what you signed up for.

There were hiccups along the way, signs that maybe it wasn’t good for you. There was the time you fell asleep at the wheel and totaled your car on Interstate 95. You were in a daze, driving home after 30+ hours awake delivering babies, doing surgeries, and rounding on patients in the hospital. You walked away fine, but the car was demolished. It was scary, but not enough to make you leave. It was like a big fight in a relationship. It made you realize your shortcomings and problems with a system that encourages working in unsafe conditions, but you decide it was just a mistake. Next time you’ll sleep at the hospital first before heading home. You think it is your fault and can’t be the relationship that is broken.

Or perhaps, the time when you were in your first year of obstetrics training. Your hands were shaking from adrenaline after a tough delivery. You breathe a sigh of relief when the baby’s limp body begins to move, and he gasps for air. You attempt to obtain blood from the umbilical cord for testing. A large bore needle sliced its way through the flimsy protection of a rubber glove as you clumsily tried to obtain the sample. You were acutely aware that your patient has HIV. What was her viral load?

Your head spins, and suddenly you feel nauseated. Now you were potentially exposed to HIV through a needle stick. You take the antiretroviral medications prescribed to decrease your exposure risk of HIV despite the toll it takes on your body. You can barely complete your busy days in residency due to the nausea and fatigue from the medications. Thankfully, it works. After follow-up testing for over a year, you are cleared from the infectious disease physician and no longer need to worry about the exposure. You think to yourself: This is just a test of my commitment. There are risks with being a doctor, ones we agree to accept. Just as you risk opening yourself to heartbreak in a relationship by giving of yourself. In medicine, you do the same. It is for a greater purpose. You acknowledge the risk and forge on.

There were happy times too. The day you emergently took a woman with a ruptured ectopic pregnancy to the operating room, her abdomen filled with a liter of blood. You transfused life-saving blood while swiftly removing the fallopian tube that had been irreparably damaged. Your patient hugged you afterward for saving her life, and you discuss getting pregnant in the future. Two years later you embrace again, in celebration of a healthy pregnancy now growing safely in her uterus.

Or the time you discuss infertility with a patient, handing her tissues and listening intently while she tearfully describes her years of inability to get pregnant- the one thing she desires more than anything in this world. You discuss risks and benefits of a medication to enhance ovulation and review next steps. She returns several months later, absolutely beaming and you confirm her pregnancy. This is why you went into medicine.

The good times keep you going, holding on. Plus, there were the expectations and investments put into this relationship.

Now it’s been seven years in a busy obstetrics and gynecology practice. You made it through 3 of your own high risk, complicated pregnancies. You have hit your stride in practice. Confident in your skills, comfortable with your decisions, and patients are waiting to see you. You are doing all of the right things, but something has changed. Is it you? Is it the relationship?

You notice that increasingly over the last few years, health care has changed. Hospitals, administrators, employers, and even patients all seem to have a more powerful voice in the field of medicine than physicians. Physicians who have tirelessly devoted themselves to patients, often at the expense of their own families, are being marginalized. Expertise is being overlooked for cost effectiveness, patient satisfaction scores, and computerized check lists. Your love for the medicine has not changed, yet somehow everything surrounding it has.

The years invested in training amounted to 8 years after undergraduate school. In residency training, you worked over 80 hours per week for little more than minimum wage. The debt incurred from medical school was enormous. You can’t just walk away. This is a commitment. You made a promise.

Change is hard. Especially when you have invested so much. You have lost years of time with your family and friends. You missed weddings, funerals, birthdays. You feel pressure that the noble thing to do is “stick it out” and not complain. No one wants to hear a doctor complaining about their job.

It takes a health scare to make you realize that you actually do matter. Your happiness matters. Your family and time are important. The only way to recapture yourself is to leave medicine. You decide to leave this destructive relationship when you realize that you are not the problem. You are not “burned out.” The problem is the current environment in medicine which puts physicians last on the list. Your stories are not unique, and all too common amongst others in the field. Leaving for you is taking control back. Control of your life and also making a statement for those still in this unhealthy relationship. You join the increasing ranks of young physicians that are finally taking a stand and demanding better from this toxic relationship. The hope is that someone is listening.

Valerie A. Jones is a obstetrician-gynecologist who blogs at OB Doctor Mom.

Image credit: Valerie A. Jones