I Bailed On My Medical Practice


Honestly, I was never cut out to be a pathologist.

It’s true that I have a strong eye for pattern recognition of rare tumors. And I’ve got enough OCD-ishness to avoid most of the million tiny and galactic mistakes that haunt pathologists without OCD traits.

But I lack the bluster for the job.

It turns out that bluster, the gift of feeling and sounding 100% certain when you’re only 99, is the key to tolerating a profession where people’s lives are in your hands.

And that gift of pseudo-certainty makes surgeons and colleagues think you’re good, even if you’re not.

The people who thought I was an outstanding general pathologist were the few pathologists who consulted with me on most of their own tough cases. Plus maybe every cytotechnologist I ever worked with.

And my wife and kids who are completely unbiased.

When the stress from outside work escalated and combined with on-the-job stress, I reached critical mass inside. I was done. Cooked.

It was a Thursday night.

On Friday I walked into work and told them this would be my last day as a pathologist.

That was June 27, 2014, about a month ago. Since then, I’ve learned a few things.

When I’m not smothered by life-and-death stress, the world shines for me.

Sitcoms are funny. I’m still shocked.

Nobody dies if I’m an imperfect human.

The scowl wasn’t permanent. My daughter said my eyes look younger now.

The other day I caught myself smiling at a tree in our backyard. Do normal people do that?

I no longer have to open fresh colons, remove the feces by hand and hunt for invisible lymph nodes for an hour breathing toxic fumes.

The last 26 years of practice are over. The 13 years of prep and training are history.

My goal is to become an indie writer before the neurons fly south.

I didn’t quit pathology so I could write full-time. I’m not that brave.

I quit because I couldn’t go on.

But I love to write. More than anything.

And like you, my human flaws qualify me for this job.

M. Talmage Moorehead

If you’re interested in intelligent design, weird artifacts, genetics and psychology from the perspective of a nineteen-year-old “Hapa Girl,” my in-progress novel may be a fun read. The protagonist, Johanna, is a genius geneticist with a younger brother who struggles with depression. Her evolving story starts here.

It’s an experiment called, Hapa Girl DNA, a tightrope of fiction and nonfiction. “Hapa” is the Hawaiian term for “half.” Johanna is half Japanese and half Jewish. In “writing” her own novel as she lives it, she ignores some big fiction rules, partly because she’s allergic to dogma and partly because she’d rather enjoy the “writing” experience than worry about material success.

But the “rules” are essential knowledge to anyone crazy enough to break them.

If you’re a fiction writer or just curious, you could download my free e-book on fiction writing, the second to last chapter of which gives my specific take on many of the dogmatic rules of fiction writing. Downloading that 19,000 word pdf file will place you on my list of interested people who will be politely notified when my traditional version of this novel is done – possibly before the next ice age. (No spam or sharing of your email address. I haven’t written to my list yet and it’s been over a year.)

Next time you’re writing emails, if you think of it, please send my blog address (www.storiform.com) to an open-minded, highly intelligent and beautiful friend of yours. Thanks. I appreciate it. They might not, but you never know. 🙂


173 thoughts on “I Bailed On My Medical Practice

  1. radagast

    I have been reading your posts (especially this one) over and over for the last 2 years. Is your email cytopathology (at) gmail (dot) com still working? I am a pathology resident. I think we have many things in common and I would appreciate it immensely if I could send you a detailed email about my circumstances and hopefully get some advice from you.

    • Hi, Radagast,
      Sorry I didn’t reply to this sooner, but I’m glad you went ahead and emailed me anyway. I hope my long-winded reply was helpful. Yes, I agree, we have a great deal in common. I hope we stay in touch over the years. Write me any time you feel like it.
      Your pal, Talmage

  2. I dreamed of becoming a doctor at such a young age and I didn’t know where else to go after I realized I was so exhausted from pushing myself in it. My AP/CP training left me burned out two years ago after my last year as chief resident. I didn’t push through with the boards, much less go back to the hospital. Initially, I thought I just needed to deviate for a while. But while seeing the whole picture from the outside, I realized there was no depth anymore, no purpose, no kindness, not even to myself. I was raised dictated by society and family about being successful in terms of money and career, that my validation lies in how many more letters of the alphabets I can add after my name and in how many more certificates I can post on the wall that made me more defensive when people question me about what I know. I love pathology and I still do. Part of the reason why I got out was that I still have the passion for it and I wanted to preserve that. I went into teaching (college undergrad) and it gave me more purpose than I have realized in over ten years of medicine. I realized that the knowledge i gained from many years of studying and training were meant to be shared to the young minds and give them inspiration as lovers of science. I can only count a few teachers who inspired me along the way and I want to be that teacher to my students. And I’m not talking about the ones who have distinction, not even my consultants and colleagues were among those who gave me encouragement, but those who were genuinely passionate for the profession and honest as a person, not just as a doctor. I want to let my students know they are already validated by being themselves and not by their marks, that being a good daughter, son or friend is enough. And that depth and kindness matters.

    I’m blessed to have your blog and this post. And thank you for the follow!

    • Thank you so much for sharing your story here on my blog! It warms my heart to hear that your experience was so similar to mine in pathology. The human body in health and disease is so fascinating, it’s impossible not to love learning about it and understanding it. I can totally relate. But the meaninglessness of sitting in a small room breathing Xylene or formalin, being part of a subculture where the milk of human kindness has turned sour in pursuit of a career is a perfect way to ruin your life, starting with your brain and mind. Congratulations for getting out of the madness when you did. I wish I could go back and be young again, make the decision to teach and find a connection with young people in a classroom. What a better life it would have been. But, fortunately, although I’m 60, I still have enough years and neurons left to write fiction. I’m enjoying it a ton, though I struggle with the perfectionism that pathology thrust upon me.
      Do you have any interest in fiction, by the way? I’m just curious to learn something from you, if you do.
      If you’d like to contact me directly, here’s my email: cytopathology (at) gmail (dot) com.
      Kudos for your incredible courage and good judgement! Wow.

      • Thank you. That’s quite encouraging. I have never really spoken openly about leaving it since I had the ‘epiphany’. Not even to my family. Maybe I am not yet too sure myself. Finding people I can connect with since starting my blog is overwhelming and quite a therapy for my mind. I’ll be sure to contact you. Thanks!

        • “Epiphany” is the right word. In retrospect, I had several flashes of insight into the darkness of life as a pathologist before I finished the residency program, but I saw all fields of medicine as equally dark, if not worse, and I wasn’t courageous enough to change professions. I certainly should have, preferably starting in 8th grade when my mother first made it clear that I would become either a doctor or a big disappointment to her. I finally burned out on pathology after 26 years of fear and perfectionism, and felt it was necessary to quit.
          As a writer now, there’s a huge opportunity to love my work every day. That’s what counts.
          Hey, I’m looking forward to hearing from you. I guarantee that you made the right decision. Very wise and courageous, indeed. 🙂

    • Congratulations on leaving a job that was holding you back! Leaving medicine was one of the best decisions of my life. Not in terms of money, but in terms of happiness. Now if I can just write a little faster I might have a shot at becoming an indie writer! What fun. Thanks for your encouraging comment. I totally understand the importance of the work you’re doing at the ranch. One of the characters in my story thinks that it’s more than a coincidence that “dog” is God spelled backwards. “As you have done to the least of these….” You know? Well, keep up the incredible work. My dog, Halo, salutes you. Me, too! 🙂

      • Thank YOU! Yes, leaving a soul-sucking life was the best decision I made (even if it meant leaving $$ on the table). Just wish I’d done it years ago! I’d much rather be rich in spirit. Hopefully with a bit of luck (and some skills I can develop along the way), a book is in the offing. Thanks again Doc, much success as you pursue your new career and ear scratches for Halo! ღ & Sam

    • You’re so right. That’s where the stress comes from, at least in pathology. The slightest mistake throws everyone into life-and-death panic. Emotions hit the ceiling. Guilt, blame, fear of hurting a patient, fear of destroying your career. The public has unrealistic views of what western medicine can do. This attitude is similar to the surgeons’ and other doctors’ views of what pathology can do. They consider an “accurate diagnosis” to be a black-and-white affair. If you stray from this fantasy, they think you are morally and intellectually inadequate. The truth is, biological systems provide a four-dimensional matrix of gray, one spectrum of problems merging with others at the molecular level and evolving over time at the microscopic level. Surgeons believe that textbook examples of classic disease represent ultimate reality. It’s an intellectual vacuum that they’re too busy to fill. Too busy to educate themselves. You spend your career as a pathologist trying to live up to unrealistic expectations thrown at you by self-righteous “real doctors,” nearly all of whom have but a vague understand of what a pathologist does for a living. A relative of mine, an OBGYN doc at the time, summed up the typical doctor’s attitude toward pathologists when she told me, “pathologists don’t do any work.” I didn’t argue. It would only lead to anger and more insult. Anger is the tool for dealing with pathologists who don’t give the “real doctors” the black-and-white answers they demand. I’m so thankful that God has delivered me from the pressure cooker. Life is too short to miss the joy of writing fiction. I hope I can develop the ability to hold readers long enough to move beyond entertainment.

  3. As a recently retired AP/CP/Hematopathologist myself, I am laughing with glee over this with you: “I no longer have to open fresh colons, remove the feces by hand and hunt for invisible lymph nodes for an hour breathing toxic fumes.” Amen, brother! I actually wore a very attractive (not!) charcoal-filtered mask to avoid the formalin fumes. Oh, and how about measuring the distance of DCIS in microns from the inked margins of needle-directed biopsies…

    • Yes! It’s so great to be done with that nightmare. As a hematopathologist, you no doubt had to do all the heme and lymphomas for your whole group, plus a full load of surgicals and cytologies. Hey, good for you for wearing the charcoal mask while grossing. Smart! I would have done something like that, but there was no way for the dictation mic to pick up my voice with a mask on. The transcriptionists could barely hear me as it was. Congratulations on your retirement. I never made it that far. I burned out at age 58 and haven’t regretted it for a moment since. Thank God for second chances! I plan to earn a “retirement” of sorts from my writing. I notice that on your blog you say that you have been “called out of practicing medicine” to give your attention to prayer and the ministry of the Word. That’s absolutely wonderful! I feel called by God, too, though I’m not a fundamentalist Christian anymore. I would like to call myself a “non-fundamentalist Christian,” but I’m not sure that’s accurate. I want to “pick and choose” what I believe from all sources, including science and various ancient writings. Kind of makes me an infidel in many people’s minds. That’s OK. But I deeply respect the fundamentalist Christians, primarily because I think these words of the Nazarene are humanity’s only hope of survival as a species here on Earth: “Love your enemies and pray for those who persecute you.”

  4. Inese Poga Art plus Life

    I so much understand you. I’ve been dealing with medical research, writing and patient test analysis for clinical trials for 30 years. It’s at least not physically getting involved into the sick matters. Anyway, every time when I had to do some post-mortem examination translation and the standard requirements are high, I cannot just write there poetry and my thoughts about some doctor’s flaw or misdiagnosis which pretty much quite often causes people to suffer more or pass away sooner, I was like totally upset. So upset, that I refused those texts and kept doing only pharmaceutical recalls, or reviews of side effects or general clinical trial synopsis and similar stuff. We become what we have to deal with. I chose doing more art which currently is more teaching art, but I would love to simply paint. Without any regard to any sales or marketing. Do it as the main thing in life. I get totally why you are so passionate about writing. Although, your stories are very complex, you’re undeniably a very good writer.

    • Thank you for understanding where I’m coming from. It means a lot. I was primarily a surgical pathologist rather than an autopsy pathologist. The stress was over life and death issues, often with the patient on an OR table under anesthesia. Getting out of that cauldron and into creative work, plus getting off wheat and lowering my caffeine intake to near zero, has turned my life around. If I ever make money having this kind of joy and fun, it’s going to seem weird. But some people can do it. Why not someone like you or me? I’m going to keep trying to write stories that aren’t boring. But I’ve got a lot of information I feel I should cram in there, just in case one my great great grandchildren reads it and needs help. You know? Exactly the kind of thing you shouldn’t do in fiction, according to the how-to books. At least most of the details are in the orange words (links) where they do less damage to the story, hopefully. Thanks again for the encouragement, and congratulations on being an artist in every sense of the word.

  5. Pingback: M. Talmage Moorehead | THOUGHTS OF A POET IN THE RAIN

  6. Oh thank you for visiting my Enchanted Blog! It sounds like you could use a copy of The Enchanted Journey as you are naturally, on your own, stepping into it. I applaud you for listening to your heart and soul, wife and children, as you step into the stream and go with the flow. Yay for you!!!! Don’t listen to the “Should I have…” Dragons when they whisper to you. Wishing you the best.
    Dr. Segal

  7. A brave decision! You don’t have to love what you’re doing to be successful, but it sure helps you and those you love if you do.

    Blessings on the journey, and thank you for following markerlamp here on WordPress

    Tom Unfried

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