Don’t want to be a richer man
Turn and face the strange
Just gonna have to be a different man
Time may change me
But I can’t trace time”

-David Bowie

Months have passed since I last wrote.  Thoughts, musings, topics have flittered frequently through my head. But in the general chaos and anarchy that I call my life, (we are often living hour to hour in the Topin household)  as soon as these thoughts gain some traction, something comes up and steals my head space, my bandwidth. And I get wrapped up in the whirlwind of my world.

But something of late feels a bit different.  The ebbs and flows and highs and lows that seems to be the backdrop of my life..seem to no longer feel right…The familiarity of the cyclical nature of things feels…no longer safe..or comfortable…but constricting, and obstructing.


I’m sixteen. I’m tired. Bill and I are in the car driving to his summer house in Fon Du Lac. Wisconsin farmland a blur out the window as my eyes are somewhere between awake and sleep. “Rebel Rebel” starts to play on the radio. David Bowie is singing in my ear, my head, my brain, my body.  The pace, the beat, the message. I am awake now, more alive than a minute prior. And the landscape around me is a bit more focused and beautiful than it was a few minutes ago.

I’m forty five. I’m tired. Its a lazy Sunday. I’m in my car. The ping from my phone draws my eye and the New York Times banner on the screen tells me David Bowie at the age of 69 has passed away. The muted grey of the clouds and absence of visible sun seems fitting as a bit of color has left this world.


Ten years I have been at this job. That’s around 150 weekends spent in the hospital, my head and heart forced to be shared unevenly between my patients and my family. 300 days not being present and in the moment with my family, my friends. But being a dutiful servant to a thirty bed ICU, a couple of dozen floor patients, a pager or cell phone at any and all hours.  And the hangover of those weekends lingers into the next. My energy, my patience, my compassion, my empathy…spent, drained, used up, losing a little bit of who I am with it.

And now, at the age of 45, I am 10 years into the practice of medicine that I genuinely still love…but can no longer continue to practice in the same way.  I have lived most of my life in a relatively risk averse way.  When faced with a fork in the road, the route less foreboding, more secure or safe has been the default. My job has been safe. It’s steady, it’s secure. It pays the bills, puts a roof over my family’s head, it buys triathlon gear, Bob Mould concert tickets, water polo team barbecues, family trips, health insurance, retirement and college funds.   But now the familiar no longer feels safe. And what was an obvious choice at the fork years ago, doesn’t seem so evident today.


So, what does a risk-averse person do when faced with the challenge of changing the status quo? Well, nothing too crazy. I mean after all, I am who I am. Definitely nothing rash. Although the idea of hopping into my jeep, family in tow, driving away from the hospital and into the unknown… with the sun out in front pacing us and David Bowie’s “Rebel Rebel” as the  soundtrack fueling us… seems exciting and invigorating… I know the reality is that within 15 minutes we would be at each others throat over where to stop for food and my daughter would be begging me to change “that song” to Ellie Goulding. But there is something quite liberating knowing that change is coming. And the constriction around my chest feels a little less so. Work will change for me in one way or another. I don’t feel that my days as a physician are numbered. But the days as the physician I currently am are. And although I am still risk-averse, there is a little “rebel” in me. And I am willing to bet on myself to make the changes I need to. To continue to work to move closer, not farther from the balance I want. The balance between work and family.  Job and play.  Time pressures and freedom.  The doctor I want to be versus the doctor I am.  I’m ready to start walking down my new road.

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