“You have a lot of gray hair, Dr. Rothman,” my 10-year-old patient told me several months ago. But, at my most recent haircut, the stylist scrutinized my hair and then assigned me to the lowest quartile of gray. “You’re not ready for color,” he declared. “At least, not yet.”
This spring marks the 10th anniversary of my graduation from Harvard Medical School as well as my 10th wedding anniversary to my medical school colleague Carlos. The gray at my temples is just another reminder of the years slipping by.
Carlos and I just bought our first house and will get the keys this week. It is an old Spanish-style home in west Los Angeles. Last year we moved from the Navajo Reservation, where we worked for the Indian Health Service, to Los Angeles, and this year we will make it permanent. I was reading Babar to my three-year-old daughter recently, and the story showed the elephant children at home in different seasons. “Why do they always come back to the same home?” Macy asked. “Why do they not move?”
I have felt at home in all the places that I have lived—Boston, the reservation, Los Angeles. But the confluence of my 10th medical school reunion, my 10th wedding anniversary, and my first house brings an unexpected sense of resolution to the issues that weighed so heavily as I embarked on my medical career so many years ago. Sometimes premeditated, but as often not, the choices I have made over the past 10 years have defined the trajectory of my life.
When I began medical school, the future felt vague, unsettled, and remote. We attended panel after panel on choosing careers, on incorporating family into a professional life, on financial planning to deal with the astounding debt we were accruing. One panel physician described the early years of her marriage and career as “blindingly unhappy.” I vividly remember sharing a cup of tea with Carlos the evening before we began our first rotation of third year. What would happen to me? To us? The years of training ahead felt endless and oppressive.
Carlos and I married two weeks before our HMS graduation. We had each settled on a career in pediatrics and couples-matched into the Boston Combined Residency Program. Residency was so consuming that I could only focus on the most pressing goal—simply getting through the day. By the time we finished residency, I was more desperate to escape the past than embrace the future. Carlos and I headed to the Navajo Reservation for a life of adventure.
“I guess that if you know you’re not going to be there forever, it would be a fascinating place to live,” said a new acquaintance to me recently. This comment echoed many that I had heard over the six years that we lived on the reservation. Certainly I went to the rez with exactly that idea, and now looking back, I can’t place the moment when the reservation ceased to be an escape and became the defining experience of our lives. But we knew that our remote town could not be our future. And what exactly that future was, I had no idea.
Our decision to move to Los Angeles last year was as calculated as our decision to move to the reservation was carefree. Carlos’s father was ill, and we wanted to be closer. This was a move for the long term, and for the first time, I felt pressured to embark on a Career. I would have preferred to remain in Native health—I fantasized about an adobe house in Santa Fe and a job in a Pueblo Indian clinic. But I always knew that family would come first.
My career goals felt as fluid and undecided as the day I left Boston. I interviewed for a position at a private practice where signed celebrity head shots papered the cozy waiting room. The four-day workweek would allow me to prioritize family. But ultimately, it felt tolerable only in the short term, leading me in a direction I didn’t want my career to take. Instead, I chose a job at a busy free clinic in south Los Angeles because I thought it would better match the ideals that had brought me to the Navajo Reservation.
Generally, I am not much of one for anniversaries. But my 10th marks a watershed. The future feels vibrant and full of possibility. The challenges are still there, but over the years, they have shifted and now are different. I am embarking on a project to reorganize patient flow in my south LA clinic so that we can devote more energy to quality of care and less to just getting through the day. I am getting to know the community leaders that I hope will be my colleagues for years to come. Carlos and I have thus far survived the grim statistics of medical marriage that I once feared.
I am a little afraid to tell Macy that we will be moving once more, but I hope that a princess canopy for her new bedroom will soften the blow. Finally, we are settled. I have a home that looks like Santa Fe, a job that feels like the rez, and I live in Los Angeles. Not bad.
Ellen Rothman, HMS ’98, practices at a community health center in Los Angeles.
The opinions expressed in this column are not necessarily those of Harvard Medical School, its affiliated institutions, or Harvard University.
