Faustian deal.

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RustedFox

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We need some creative thought around here.



Some time ago, I found myself wandering around in a particularly inspiring setting (nature, architecture, etc), and I thought about the whole "Faustian deal". For those who are unfamiliar; wikipedia (verb) "Faust" to catch up real quick - though I suspect that most of us are familiar with the tale.

I thought to myself that I would accept a Faustian deal of sorts with either God, the "Devil", both, or neither.

I get: A superhuman number of years in my lifespan and healthspan. Specifically - I wish to be free of serious injury or terminal illness for at least 150 years from my present 33 years of age... preferably ad infinitum. I'd take immortality on this plane if it were offered. I will never have a permanent disability, develop CAD, pulm HTN, cancer, Alzheimer's, Parkinson's, etc. Similarly, I want my wife to enjoy the same benefit; "til death do us part" and all. I wouldn't mind aging in a delayed fashion, or needing to move after every so many years to conceal my youthfulness.

The ethereal contract holder gets: A guarantee that I work for at least 130 hours/month in the ER (or whatever sector of the healthcare world that I can provide service in at that time period in history... lets say I do a tox fellowship, or do another IM residency, or whatever other educational avenues arise in the year 2073 when disco finally comes back)... Anyways, God/Satan gets indentured medical servitude from me for the term of the agreement, and I will always perform to the best of my ability and serve in a leadership role to achieve the contract holder's best interest. If Satan wishes to destroy the US healthcare system by ordering a serum porcelain level on every triage level 3 patient... so be it - I'm game. I get it. I'm your confederate.

Reasons why I think I get the best of the deal:

1.) I like my job. A lot. Medicine is fascinating, and always evolving. I've read more research in this past academic year than I ever did during seven years of medical school and residency. I read PubMed every day. Its better than People.
2.) I think (after a long amount of self-reflection) that the reason that I chose a career and life in medicine is because of the nobility of it. I really, honestly, do feel at some point on every shift that "all men are my brothers" and all that feelgood stuff. Mock me if you will (Veers). As long as I have a brother (or sister) to serve, it is my pleasure to do so.
3.) I work a lot right now (I've done 150+ hours a month for the past two, and for a good stretch of months before I got hitched in April in order to make-make money-money), and I still feel that I can enjoy the things that make life flavorful for me. I would love to follow baseball and hockey for the next 150 or so years. Every year. Spring is the best. Preseason baseball AND playoff hockey ?! WIN! I would love to do the small things that only take a 2-3 day stretch (swim with manatees, go take an airboat tour of the everglades, party hard after a really killer concert) for EVER. Creatively, its easy to do fun things that don't require you to block off 2+ weeks in this subsection of medicine that we live in.
4.) History. Nostalgia is the best. There's this show on AMC (also available on Amazon Prime Video) now called "Halt and Catch Fire". It explores the PC revolution of the 1980s. I remember using a dial-up modem to connect to local BBS services in the late 80s/early 90s. Look at where we are at now. The show is the BEST. Imagine every 20-30 years being able to look back at yourself and say "Wooowww, maa'aan!" How great was THAT !?!
5.) The term of the contract is long enough that it can probably be renewed, extended, or renegotiated at some point. It can probably also be bought out by the opposite ethereal force, not unlike our ED contracts of present day.

I could go on, but I'm going to pull back at this point and let y'all take over. Post the terms of your own Faustian deals, predict the emerging fellowships of 2073, or take this in your own direction.




The overarching point here, I guess is: For all the complaining that we do about our jobs, and how much we all need to have an endgame or an "exit strategy" for EM...


It's really not that bad. Keep your heads up, cowboys.

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I have a 12-hour nightshift tonight. Give me something to read and entertain myself with, guys.

Go.
 
Yeah, see, I don't see the downside of your deal. It looks like all gravy to me. Generally, a bargain like that has to come at some cost to the person, and having steady work that you enjoy or at least can find some redeeming aspects to appreciate, living to superadvanced age with certainty of continued health and wellbeing, and having assurance that your partner will be with you enjoying same... what isn't agreeable with all that?

Now... a Faustian bargain would be if you got to live so long, with assured wealth and a happy healthy spouse, but had to work in hospital administration. No patient contact, just policy enforcement. Yecch!
 
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Yeah, see, I don't see the downside of your deal. It looks like all gravy to me. Generally, a bargain like that has to come at some cost to the person, and having steady work that you enjoy or at least can find some redeeming aspects to appreciate, living to superadvanced age with certainty of continued health and wellbeing, and having assurance that your partner will be with you enjoying same... what isn't agreeable with all that?

Now... a Faustian bargain would be if you got to live so long, with assured wealth and a happy healthy spouse, but had to work in hospital administration. No patient contact, just policy enforcement. Yecch!

Its the "indentured servitude" that's the downside. You can't "leave" the job, like we all scream from time to time that we're going to do immediately, as soon as....
 
I get you. Indenture does suck. I guess I am just a cheap date. I've bargained for a lot less... I took on a 4 year indenture to pay for nursing school. I mean, I could have quit early, but it would have cost me tens of thousands to do so. I am taking on similar commitments to pay for med school.


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are you factoring kids into this 150 year deal? I think your priorities and extracurriculars may shift once you encounter that curve-ball.

Also, your deal works well for LCOL + high pay areas, but not so much the other way around. How much longer after 150 yrs do you live? Or do you die right away? Do you need to save for retirement?
 
We need some creative thought around here.



Some time ago, I found myself wandering around in a particularly inspiring setting (nature, architecture, etc), and I thought about the whole "Faustian deal". For those who are unfamiliar; wikipedia (verb) "Faust" to catch up real quick - though I suspect that most of us are familiar with the tale.

I thought to myself that I would accept a Faustian deal of sorts with either God, the "Devil", both, or neither.

I get: A superhuman number of years in my lifespan and healthspan. Specifically - I wish to be free of serious injury or terminal illness for at least 150 years from my present 33 years of age... preferably ad infinitum. I'd take immortality on this plane if it were offered. I will never have a permanent disability, develop CAD, pulm HTN, cancer, Alzheimer's, Parkinson's, etc. Similarly, I want my wife to enjoy the same benefit; "til death do us part" and all. I wouldn't mind aging in a delayed fashion, or needing to move after every so many years to conceal my youthfulness.

The ethereal contract holder gets: A guarantee that I work for at least 130 hours/month in the ER (or whatever sector of the healthcare world that I can provide service in at that time period in history... lets say I do a tox fellowship, or do another IM residency, or whatever other educational avenues arise in the year 2073 when disco finally comes back)... Anyways, God/Satan gets indentured medical servitude from me for the term of the agreement, and I will always perform to the best of my ability and serve in a leadership role to achieve the contract holder's best interest. If Satan wishes to destroy the US healthcare system by ordering a serum porcelain level on every triage level 3 patient... so be it - I'm game. I get it. I'm your confederate.

Reasons why I think I get the best of the deal:

1.) I like my job. A lot. Medicine is fascinating, and always evolving. I've read more research in this past academic year than I ever did during seven years of medical school and residency. I read PubMed every day. Its better than People.
2.) I think (after a long amount of self-reflection) that the reason that I chose a career and life in medicine is because of the nobility of it. I really, honestly, do feel at some point on every shift that "all men are my brothers" and all that feelgood stuff. Mock me if you will (Veers). As long as I have a brother (or sister) to serve, it is my pleasure to do so.
3.) I work a lot right now (I've done 150+ hours a month for the past two, and for a good stretch of months before I got hitched in April in order to make-make money-money), and I still feel that I can enjoy the things that make life flavorful for me. I would love to follow baseball and hockey for the next 150 or so years. Every year. Spring is the best. Preseason baseball AND playoff hockey ?! WIN! I would love to do the small things that only take a 2-3 day stretch (swim with manatees, go take an airboat tour of the everglades, party hard after a really killer concert) for EVER. Creatively, its easy to do fun things that don't require you to block off 2+ weeks in this subsection of medicine that we live in.
4.) History. Nostalgia is the best. There's this show on AMC (also available on Amazon Prime Video) now called "Halt and Catch Fire". It explores the PC revolution of the 1980s. I remember using a dial-up modem to connect to local BBS services in the late 80s/early 90s. Look at where we are at now. The show is the BEST. Imagine every 20-30 years being able to look back at yourself and say "Wooowww, maa'aan!" How great was THAT !?!
5.) The term of the contract is long enough that it can probably be renewed, extended, or renegotiated at some point. It can probably also be bought out by the opposite ethereal force, not unlike our ED contracts of present day.

I could go on, but I'm going to pull back at this point and let y'all take over. Post the terms of your own Faustian deals, predict the emerging fellowships of 2073, or take this in your own direction.




The overarching point here, I guess is: For all the complaining that we do about our jobs, and how much we all need to have an endgame or an "exit strategy" for EM...


It's really not that bad. Keep your heads up, cowboys.
You need one thing and one thing only. You need to be able to sleep at night, and be awake during the day. Every day. Every night. The rest of your life. Make your deal. No one else will.
 
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are you factoring kids into this 150 year deal? I think your priorities and extracurriculars may shift once you encounter that curve-ball.

Also, your deal works well for LCOL + high pay areas, but not so much the other way around. How much longer after 150 yrs do you live? Or do you die right away? Do you need to save for retirement?

We will never have kids. I'm actually going to go get "fixed" next month.

I did not consider the how much loner after 150 years do I get to life. I'd take immortality and eternal servitude.
 
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The devil is typically in the details..the fine print...so let's add getting sued in perpetuity or something like that a monkey wrench as it were. Sounds like the Faustian bargain already is likely what you are missing now thst you don't know you are missing now or the burnout that's creeping up just as you say you can go forever.

My Faustian bargain...just starting practice to bring in money and of course satisfaction with work even as I have a three month old. If I had maternity leave options perhaps I wouldn't have negotiated as such. A boring one....family vs career and income. But relatable by many. Perhaps what makes it Faustian is the perpetuity of lineage. Otherwise it's just plain old dealing with the devil.
 
Wait a sec...Faust is soul for knowledfe/power. Mine is family life for intellectually stimulating and money coming in. Similar. Money is power no matter how little or how much. Family quotidian minutiae is soul.

Thankfully both are about caring for others. So not having to compromise values to earn money to live. Thankfully private practice where I am means less enslaved with beaurocracy so far. That feels lucky.
 
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