Sabbatical, Step 2: An Exit Plan

Research. Reading. Mulling it over. Think about it. Ponder. Discern.

To heck with it. Sometimes, you just have to do it (sorry, Phil Knight!)

I didn’t know what I wanted, but I knew it wasn’t THIS. Sonia thought that was enough of a plan. If it was good enough for her, then it was good enough for me. (Retrospectively, now that I have a “soft landing”, it’s easier to see. More on that last piece in about 3 or 4 entries. Cliff-hanger!)

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What follows here isn’t a plan that necessarily is generalizable from me to someone else. It is what we did, and it worked for us. 2016 was all about a plan. Maybe it’s more of an outline, and I think you will be able to ascertain why that’s a better term. We had a framework of what needed to happen, but we definitely did not have all the details. That bothered me; it didn’t bother Sonia. Remember, her dad retired early in the Reagan, enjoy the surface 80s. She has a PhD in “making-it-up-as-you-go.”

-Assess finances

The practical portion. This is the reality of adulting and not being an heir to a fortune. Can we afford to do what we want to do? And how long can we afford to do it?

We had three cards up our sleeves. 1. We don’t have expensive tastes. 2. We were fortunate and had a rainy-day fund; we actually thought it was more of an early retirement fund. I guess it was that as well, and we just never knew it would be THIS early. 3. We opted several years prior to my exit to enroll in an HSA in our company.

We sat down and crunched numbers. A lot. We ran best case, worst case, and realistic scenarios. We looked at other things that we could cut from our costs (thankfully, we didn’t have a lot of this to do). One can’t cut steak and lobster from their shopping list if one doesn’t eat steak and lobster to begin with.

We looked at vehicles, appliances, home repairs, and Sonia’s sewing business. We thought about it all. Groceries, clothes, deodorant. We had a number for it. Understanding that these are all estimates; one can’t budget for backing into the garage door. Not that I did that two weeks ago.

The numbers pointed to if we lived modestly (not a big change for us), that I could take close to two years off before income was an issue. Obviously, there was some play in that estimate, but it gave us a place to start from. And we didn’t do this step by step. We worked and revisited several angles simultaneously. But this is the outline:

-Deciding how long to take off

Now that I knew what the absolute limit was, what did I want to do? What did I need to do? I had never done anything like this before. Blueprints just don’t exist.

Here’s what I did know.

Like most people, I make worse decisions when I’m exhausted.

I needed to WANT to do something.

I had to wait for inspiration.

In practical terms, Sonia told me that from her perspective, I needed to take AT LEAST 12 months off. Given meningitis, an upper endoscopy, migraines, and pneumonia, she didn’t see a way where doing anything productive before the start of 2018 was reasonable. I largely agreed with her. After that, well, we would deal with it. That was a good enough plan.

I also knew that I would probably have to start looking before 12 months were up, but actually starting something before the end of 2018 was off the table.

Great, I had a time frame. Now what?

-Seeking informal counsel for emotional support

I sought out a few people to talk to. I did not seek out career advice because I couldn’t think that specifically. The type of counsel I sought out was more to “prepare my own soul” as I sorted through a variety of emotions. I had to be careful who I talked with, because I wanted to keep a lot of my thought processes and plans quiet. Speaking with anyone even remotely medically related was out. I didn’t have time to seek out a therapist or psychologist. The list grew shorter.

Where could I turn for someone that I could trust, and that understood confidentiality?

As it turns out, for whatever reason, I’m friends with a lot of pastors. A number of whom have gone through their own career changes (leaving corporate America for the ministry, or having plotted out slightly different careers on their own.) Splendid! I could talk to people that knew where I was coming from in a general sense AND that understood privacy. I drank a lot of coffee at Kaldi’s, explained what I was trying to do, and listened to their advice. Now I had something resembling guidance on a practical and personal level. And they didn’t flinch when I dropped a few f-bombs, which for me falls under the category of “typical day.”

-Preparing the family

We talked to our immediate family a lot, and asked them to keep these cards close to their vest. Given the amount of support we needed just to get through medical school and residency, we thought it best not to come in high-and-tight with a 98 mph fastball on Jan. 1, 2017 and say “surprise!”

Yes, I was leaving my career.

No, I’m not insane, at least not for this reason.

Yes, I’m intentionally taking a big chunk of time off.

Yes, we have health insurance. (This came up. It’s a big ticket and very practical item).

No, we don’t need a loan. And I’m sure I’m not insane. Stop asking.

Our families were very supportive. I guess it helps that both of us grew up in families that cared little for status and focused more on “doing the right thing.” In fact, I don’t recall anyone in our immediate families expressing concern or amazement at all. It was more of an attitude of, “ok, I can see this. How can we help?” I’m lucky. And grateful.

We also had to prep our children. Kids talk about their parents. Their teachers might know or sense a change at home. We had to give them advanced notice about our plan. For the most part, our kids are pretty mature and have an awareness of the world around them. Rather than sugarcoat anything, we just leveled with them. I’m sure they were nervous at times, but they expressed more excitement than worry.

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Ice skating at a local park this past winter; something I never had the time to do before. Even when I got nervous about the future, I never regretted my decision. This was the stuff I missed on a regular basis.


-Plan for fun

I can’t stress this enough. If one is going to drastically change careers and build in a “breather”, then we had to do so something fun, and a little offbeat (and comparatively inexpensive). This is where Sonia excels. As I’ve mentioned before, she’s is used to and encourages taking control and bucking the system.

She spoke fondly of the huge six week trip she took with her parents when they lived in Dallas. She remembers her trip to Sweden that her father negotiated very fondly. While we weren’t in the position to hop around Europe, we were in the position to do something unique.

#1 – we hadn’t visited any of our siblings in their towns over the holidays. Chicago for Christmas? Check. Sacramento for New Year’s? Check. Don’t come to us, we’ll come to you.

Spring Break. Our children had been to New Mexico once to see their mother’s home state. There’s a lot more to see. We wanted to see some of the national parks and other parts of the state that were a little off the beaten path. Southern New Mexico in March 2017? Check.

Summer vacation. Let’s disappear and see how long we can stay on the road. Hell, let’s drive all the way to California and back. Let’s hit some more national parks. Sure, let’s be cheesy and hit Route 66. Drop in on a college friend we haven’t seen in 17 years? Why not! Griswold comparisons aside, we hopped around the southwestern and western United States for 4 weeks. Crazy idea? Check.

But we planned for other things around St. Louis. We literally budgeted and planned for fun. I had to know that it was acceptable to do things other than sit in burlap in a pile of ashes. I needed to know that it was ok to be a little wacky and do some non-traditional stuff. The concept bothered me a bit in the abstract. Once I saw it in front of me as a budget item, I was surprisingly ok with it. I guess one piece of advice is to make sure that you are at peace with your own plan.

-Wait for inspiration

A corollary of one of my earlier points. I had a timeline before I wanted to go back to work, and a time frame we could live with, both with the financial aspects as well as just old fashioned recharging of the mind and spirit.

I promised Sonia that I wasn’t going to start researching careers on Jan. 1, 2017. I needed to WANT it again. To WANT to look. To WANT to research. To WANT to work in a productive capacity.

How would I know? Sonia assured me that I’ve never been lazy. The want will come back. Give it time. Don’t make a plan to get into a certain field right away. Once the desire to do SOMETHING returned, then I’d be ready to do the groundwork on picking the specifics. But I was under strict orders not to even think about it until the desire came back. In full disclosure, I was way more worried about this part than was Sonia.

Once again, she was right.

I’ll get to this last point in a few entries, but the one budget item we didn’t account for was formal career counseling. Fortunately, I’m very practical about being able to turn a buck, and was able to handle this non-budgeted expense in the end. If you are reading this to apply any of my situation to your own, I would research this part FIRST and account for this cost. More on that next entry.

-To give up my license, or not give up my license, that is the question.

Another big question. Do I drop the money to keep licensure while I’m waiting for inspiration? Just in case if I’m wrong about all of this?

Once again, I had to be brutally honest with myself.

I knew myself well enough by this point. If I left this door open, even if slightly, I would be strongly tempted to abort the sabbatical in a few months, and just go back to what I was doing.

Was part of the problem the culture of working in medicine? Yes.

But as I’ve acknowledged, part of it (and a large part) was me. Yes, I’m a driven and motivated person. There’s more than one way to use these skills for good.

I hate to leave notes about “I’ll address this in a few blogs”, but this will be a big theme. And it’s probably sound career advice. Know thyself. Really. Actually understand yourself. Don’t kid yourself. We can change many things about how we live as people, but some things are just essential to who we actually are as individuals.

Was the only problem the culture of medicine? NO.

Time to take some ownership. Part of the problem was me. Maybe the best use of my skills – given who I am as a person – now belonged someplace else.

For the record, I’m insanely proud of what I did in 13.5 years of medicine. I’m proud of the people I helped, and I’m grateful for the people that helped me. I’m a better person due to the people I worked with and the people I met. I did things that to this day I believe a lot of people couldn’t have done. I’m therefore proud of what I did and with whom I did it. I regret NOTHING.

But the honest answer was that I didn’t want to do this anymore. I didn’t know what I wanted, but it was something different. And if I left the bridge standing to my old world, I would go back across it.

Therefore, there does not exist an interesting story as to why I left. No juicy details. No lawsuit. No failure to pass exams. No issue with any licensing body. If you Google it, you won’t find much. Last check, my ratings from my patients are the same as they were 16 months ago.

I made the active decision to walk away. I literally gave it up. I gave up. Quit. Took my ball and went home. It wasn’t forced upon me.

Now that I have a new career to focus on, it’s easier to say publicly. But I’ve know it on some level from day one. It was my decision; no one made me do this. It wasn’t a passive of choice of “this is my only option.” This was a very active and conscious decision. I decided to not pay for certification and licensure. Otherwise, I would have gone back and tried another time. I wouldn’t have learned my lesson.

I can’t stress enough how important it is to truly understand what taking a sabbatical is. If the purpose is to change, then do the requisite work to make the necessary changes. I don’t know if I can make a blanket statement to anyone thinking about leaving medicine or nursing about what to do about certification and licensure. I do think that there are things to think about, but no blanket response.

But I knew what was right for me. No ultimatum was given by family. There were no external threats.

I needed to change, so I started to change.

It’s very simple.

Now that I made that decision, I had to learn something very hard for me. I had to learn how to rest and recover. I literally had to work at the next step; I had to work on resting. Future planning depended upon it.

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A caricature of yours truly, courtesy of Allison Kesselring.
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Author: Jason Kesselring

I am a 40 year old pediatrician transitioning to a teaching career, happily married, and a father of two wonderful children. I fell out of the Ugly Tree, and hit every branch on the way down.

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