Empty Hands

September 4, 2015

When more isn’t better in radiology.

Sometime during college, I took note of a semester’s end phenomenon: As various classes had their final exams or other culminations over a one to two week duration, the number of students walking around campus encumbered by texts, notebooks, and stuff in general steadily diminished.

I always seemed to have at least one class with an exam on the last possible day, and would increasingly enviously regard my peers strolling around campus carrying nothing at all while I still had academic burdens occupying my arms. When I finally joined their ranks, I greatly relished the freedom of having nothing to carry.

The happy liberation from material possessions carried on through med school and residency, and I came to regard the ability to go about one’s business empty-handed as a rare luxury. At times, textbooks, pocket references, or lab coat pockets stuffed with syringes and index cards seemed to me as the human equivalent of a horse’s saddle and bridle. It wasn’t limited to health care; lawyers had their briefcases, tradesmen various assortments of tools, etc.

Relishing empty-handedness was a bit counterintuitive because, to borrow from the late, great George Carlin, we judge much of our success on the basis of how much stuff we’ve managed to acquire. Carrying around that stuff keeps it handy for us to use, and conveniently lets us show off what we’ve got. If I stroll down a hospital hallway wearing regular clothing and nothing in hand, I’ll get a much different reaction than if I’m clad in white coat, stethoscope around my neck, pockets brimming, clipboard in hand, etc.[[{"type":"media","view_mode":"media_crop","fid":"41061","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_3140710746785","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4278","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 247px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Leo Blanchette/Shutterstock.com","typeof":"foaf:Image"}}]]

Even more counterintuitive has been the realization that there are less tangible ways to wind up without the freedom of empty-handedness. A very common one, especially to those of us with advanced degrees, is debt. Student loans, mortgages, credit accounts carrying balances from month to month…unlike textbooks which can be shelved or sold at the end of a semester, these burdens can take far longer and be much tougher to lay down.

The most insidious of all are the intangibles one doesn’t even recognize as burdensome when taken on (or as they proceed to be carried for years afterwards). A partnership position, for instance, in a radiology group. For many, it’s a knee-jerk sentiment: Of course you want to be a partner instead of an employee. Until the day comes along that you wish you hadn’t tied your fate to this particular group, and start wondering what it will take to extract yourself from it.

Ditto for a hard won position as a section head or department chair. Resigning from such a post won’t be quite the legal and financial mess as the scenario above, but there will be consideration as to how this might impact one’s chances to get such posts in the future. And, having climbed this far up the ladder in one’s current venue, can one countenance going to a lower rung-in the same place, or elsewhere? Jacob Marley’s chains come to mind as a comparable burden.