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A doctor dies twice

Baird Brightman, PhD
Physician
December 23, 2019
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I have had the opportunity to consult with several physicians who needed to abruptly and permanently give up the practice of their chosen career without their consent. Causes of this involuntary termination included illness, burnout, and loss of license. What became very clear to them and to me was that the standard strategies for managing a work transition (e.g., defining transferable skills, exploring a range of job/work opportunities, learning new things, revising the resume, networking, etc.) were going to be necessary — but by no means sufficient to adequately assist them in managing the traumatic change they were facing. There was another level of work that would need to be done before, in parallel with, and even after they made the transition to their next career chapter.

One of the first things people ask us is: “What do you do?”

We are, in part, what we work at. It turns out that people experience different degrees of separation between their personal identity (“self”) and their work identity. Some people view their work as a job. It is mostly a way to make money and is viewed as largely separate from who they “really” are in their lives. Others view their work as a career. Here there is more intermingling of the personal and work selves around core interests and abilities.

A minority of adults view their work as a calling. In this case, the work identity occupies a very large part of the self’s real estate and engages deep values and a sense of life’s purpose/meaning. For the physicians mentioned above, their work was definitely a calling, and its sudden and unplanned loss ushered in a dark season of the soul.

In an evocative article about the end of a dancer’s career, the choreographer Martha Graham is quoted as saying, “A dancer dies twice — once when they stop dancing, and this first death is the more painful.”

The end of a career, which is a calling, is indeed like a death of the self. It is the end of the opportunity to exercise much of what one is and values in a fully engaging and absorbing frame. To pursue a calling is a very deep form of happiness, and its ending is a grievous loss.

People who have lost so much of who they are need frequent opportunities to both remember (hold on) and to grieve (let go). They are in a zone of life experience, not dissimilar to a person who has lost a loved one or a part of their own body. The loss of the opportunity to do work that is a calling can rob life of its joy and purpose and hope. The prescription to “just heal and move on” is glib and dismissive, whether delivered to a person who has lost a calling, a spouse or a child, or a limb or the full functioning of their brain. It minimizes the magnitude of the mental work that needs to be completed before much energy or optimism for a new venture can be found.

To remember, recall and reminisce about what one has lost is vitally necessary for two reasons. First, it allows a person to hold onto parts of themselves and the world without which they would not be able to function. Memories are lifelines to the world that was — even if it no longer exists to the external senses. It allows us to hold on longer for as long as we need to, and this provides safety, control, and comfort to the afflicted. Second, each remembering triggers a simultaneous recognition of how much is lost and the grieving that is necessary to fully live after deep loss.

We are programmed by evolution and natural selection to experience the loss of important connections as painful so that we will not let go of those vital attachments without a fight. Grief must be felt deeply, and often before the mind can become free to create new attachments.

A number of approaches enable this remembering and grieving to be done, and different people will find different avenues to be most suitable in dealing with the loss of a calling. Some people find value in talking with a trusted person about what has been lost. Others benefit from meeting with a group of people who are dealing with a similar loss. Journaling, drawing, painting, sculpting, photography, videography, acting, music, and other creative routes to representing and remembering can be valuable to people who have some facility with those forms of expression.

A person who has lost a calling should not be asked to do the impossible, which would be to say goodbye quickly and walk away from a deep part of who they are and will continue to be. While the loss of their chosen career may not have been in a person’s control, the manner in which they cope with that loss must be. Otherwise, they will suffer a double trauma and be at risk for despair, addiction, and worse.

For people who have lost a calling (as well as those who have lost a spouse, a child, or a part of their physical self), coping with the loss of such a vital part of their world takes a lifetime. It involves an ongoing process of remembering and grieving (ideally not in isolation), meaning and perspective making and creation of new professional attachments that can compensate for but never replace what has been lost.

Baird Brightman is a behavioral scientist and can be reached at his self-titled site, Baird Brightman PhD.

Image credit: Shutterstock.com

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A doctor dies twice
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