The fat purple fig of public health

Here's some New Year's reading for you: 

I saw my life branching out before me like the green fig tree in the story. From the tip of every branch, like a fat purple fig, a wonderful future beckoned and winked. One fig was a husband and a happy home and children, and another fig was a famous poet and another fig was a brilliant professor, and another fig was Ee Gee, the amazing editor, and another fig was Europe and Africa and South America, and another fig was Constantin and Socrates and Attila and a pack of other lovers with queer names and offbeat professions, and another fig was an Olympic lady crew champion, and beyond and above these figs were many more figs I couldn't quite make out. I saw myself sitting in the crotch of this fig tree, starving to death, just because I couldn't make up my mind which of the figs I would choose. I wanted each and every one of them, but choosing one meant losing all the rest, and, as I sat there, unable to decide, the figs began to wrinkle and go black, and, one by one, they plopped to the ground at my feet. 

                                                                                                        - Sylvia Plath, The Bell Jar

Yes. I've always wanted each and every fig. In my twenties it felt like I could have them all, eventually. I turned forty and saw that the time remaining was finite. I sat there a while, having to choose, unable to decide. I considered Pete and his career, each of our kids, and our life in Vancouver. I cycled through all of the options, repeatedly. 

A year ago I wrote:  "And so 2015 felt to me like the year of endings, but not quite of beginnings. The beginning of beginnings, maybe. The Year of the Lull. An intermission. It was restful but I'm restless. I'm about ready to lay down the ten year plan. 2016 will be the year of decisions. It will be the year of beginnings. Fingers crossed, one of those beginnings is the foreword to my first book."

I did decide. I chose a Public Health and Preventive Medicine residency at UBC, and, as I learned on a 9 am phone call back in June, it chose me back. It's a five-year specialty training program, but I get full credit for my two years of family medicine residency. I started in September. Every night at dinner the family learns about rabies, or the Canada Health Act, or a kindergarten in Tokyo with a circular playground roof where the kids spontaneously run 4km of laps every day. All four of my kids can tell you about Typhoid Mary. 

I didn't write a word for four months. I'd been writing several hours a day for much of the year prior. My phone has a lot of pre-September photos that look like this, me and my muse, with reams of paper in the background. Then not one photo until Christmas vacation.

But over Christmas break, I did write the foreword to my book. It has a publisher! The manuscript has now gone to the editor. It looks like we have a title in our sights. Formal book announcement coming soon. 

Which figs will I let wrinkle and go black? A regular full-time family practice in Vancouver. A practice focused on care of the elderly. Unhurried days in a quiet house, at least for the next three years. The other areas that appeal to me - refugee health, medical education, mental health - will likely reappear as part of my public health career. 

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Deep Cove and I renewed our vows. Pete and I considered moving back into Vancouver, close to UBC, but the kids are thriving in their North Shore school. It's K-12, which means all four kids are at the same school. So we've stayed put, and I commute. It's 48 minutes each way, four days a week. It's not a problem. I have my best ideas in the car. 

We advertised for a nanny/housekeeper for three days a week back in September, but got no bites. We ended up with no hired help this fall. I bought a Dyson vacuum instead. I've decided that I'm a permissive doctor by choice, a permissive housekeeper by necessity, a strict parent, and a ruthless editor (of gardens, words, personal belongings). Quite balanced overall.

Things are peaceful on the home front. I study a lot, but I'm around. The amount of homework I do and the pleasure with which I do it is not lost on the kids. They're five to fifteen - a sweet spot, I think. They're increasingly independent, but have not yet made any decisions of which I disapprove.

*   *   *   *   *  

2016 was a good year for me. The restlessness is gone. I feel engaged and focused. Doing the work is a whole lot easier than deciding which work that's going to be.