“In the beginner’s mind there are many possibilities,
but in the expert’s there are few” ― Shunryu Suzuki
“It ain’t what you don’t know that gets you into trouble.
It’s what you know for sure that just ain’t so." ― Mark Twain
As I gain experience in my career as a physician, it is easy for me to develop tunnel vision. Not about my patients, their diagnoses, and their treatment. In fact, one would hope that my field of view gets wider in these regards as I become more knowledgeable and learn to resist the forces of premature closure and diagnostic momentum. Rather, the tunnel vision I develop pertains to myself. I practice in a certain way, chart in a certain way, work in a particular position in a particular career for a particular amount of money in exchange for a particular lifestyle. I assume these things are more or less immutable. And then when I find that I am unhappy, I feel (and, perhaps, think and act) like a caged animal.
Self narratives vs. reality
Of course, none of these assumptions are true. In five years I could be leading a completely different life. I could get a new position, move to a new location, adopt new working habits, work harder in exchange for more money, work less hard in exchange for less money, buy a bigger house, buy a smaller house. Heck, in 5 years I could even change specialties or leave medicine altogether. As I consider these options, of course, objections instantly arise. I can't move because of family commitments. My hospital administration won't cooperate. I have college tuition to pay and can't possibly afford to make less money. I already work a gazillion hours—how could I even consider working more?
You may recognize some of these narratives—stories we tell ourselves so many times we have started to believe them. But if I pause, and study my newest partners I realize they have dreams. They are going places. They have a vision of the kind of career and life they want, and gosh darn it they are going to get there. There is absolutely no reason I cannot join them on their exciting journey to Where They Want To Go.
Counter arguments
"But they have no tuition payments! They have no kids and spouses and mortgages!" One objection after another comes flooding back. And there is truth in them--some effort will be required to unwind the ball of string that is my current way of life and rewind it the way I want it to be. I did not say I could have an entirely different life tomorrow. I said in five years. But hopefully—and almost certainly—I will still be here in five years.
Each of us needs to do "five-year-from-now-you" a big favor. Take one step in the direction you want to go. And then the next step. And then the next step. And then...you get the idea. It may not even take five years. Stanford computer scientist Roy Amara (and then countless famous people and self help gurus ever since) said, "Most people overestimate what they can achieve in a year and underestimate what they can achieve in ten years." But I am not so sure that is necessarily true. I have surprised myself recently by how much one actually can change in just a year. Maybe not a new career, but at least plenty of progress to keep you excited and moving in the right direction.
Think about the one aspect of your life you would most like to change, or one dream you have for your future self that you find most exciting. Write down three steps you can take in the next 48 hours to move towards this goal. These might be conversations with people to start to come up with a plan. They might include gathering information about training. They might be preparing for, scheduling, and attending a meeting with a boss to have a crucial conversation. They might be asking your musically talented adolescent what kind of guitar to buy and then going and buying it and signing up for lessons. They might include talking with a spouse or partner about your goals and dreams. They might be asking three colleagues how they chart so efficiently. Just three simple things. Write them down. Now do them. Future you can't wait for you to get started.