One Year Later (I)
A year of travel, becoming, and despair
I was down and feeling like I had no cards left to play. I had moved my family to California, abandoning a year-long training program after only nine months, hoping to start a new chapter in my life. Except, that never happened. My well-laid plans left me in a ditch of depression, despair, and credit card loans. The bills were piling up, credit cards maxxing out, no source of income except my wife’s salary, which was not covering even 50% of our monthly expenditures. I kept trying to crawl out of that ditch, but every time I kept falling deeper and deeper. It was hard to keep up appearances. I restarted therapy, started water aerobics and took swim classes. I couldn’t change my outside, but I still had some control on the inside, which I tried to work on that. I was anxious, depressed, and waiting for a miracle.
One year ago, on July 15th, 2024, I found a tunnel out of the ditch of darkness. I received a phone call around 2 pm. It was a locum agent (CH). He told me that a hospital in Michigan was willing to give me a chance and that I would be going there starting in August. Locum Tenens is like travel nurses but for doctors. I almost started jumping with joy. It was the first good news I had received that year. Even getting that assignment hadn’t been smooth and without its bumps.
I had spoken to the other doctor at the facility, a veteran of my specialty, on July 3rd. Our call had gone like most job interviews. Where did you go to medical school? Residency? Fellowships? Why did you leave your last fellowship early? I told him that it was because of a ‘toxic workplace’. I probably shouldn’t have said that. Even on the phone, I felt his demeanor change. Two days later, he emailed the agent that I had “prematurely left the fellowship training program in March, “due to a toxic environment” instead of finishing the program.” He also mentioned that I had no working experience and that for locum coverage, he needed someone who can work “independently and confidently day one”.
That felt like a dagger to my heart. The week prior to this (July 1st), I had been informed by the Medical Board of California a.k.a MBC (after three months of pleading with them), that I was not eligible for a full medical license. I had been waiting since April to get an update on this so that I could start my job in Fresno, California. That door had been closed on me, forcing me to look elsewhere. It also meant that I would have to go work elsewhere while my family stayed behind. For the Fourth of July weekend, I was visiting San Francisco to see a high-school classmate. On my way back, as I was crossing the Bay Bridge, I got a call from the practice in Fresno who had offered me a job. I had sent them MBC’s decision. The practice manager told me that they were withdrawing my job offer. During the same three-hour drive, I got a call from a recruiter in Philadelphia about a permanent job.
I had started looking for alternatives only in June, amidst the uncertainty and frustration caused by MBC. One of my friends had suggested applying for a license in other states. I had also started applying for locum jobs everywhere. I spoke with multiple locum agents (starting on June 10th), but without any active licenses, those calls went nowhere. Finally, I got my first license in Michigan by the end of June.
For the Michigan job, after the first phone call and the feedback, I had to get additional references and send a statement saying I could work independently. I had never done it, but there’s a first time for everything. That was the best I could offer. Until July 15th, I was hopeless. Once the phone call was over with CH, I was euphoric. I ran upstairs and woke up my wife from her nap to give her the good news. Then I texted some friends in Michigan about it. I had three weeks left with my family before I was leaving for at least two months.
I had been waiting for someone to take a chance on me. No one was willing to give a job to someone with no experience and an unfinished fellowship. That’s where CH came in. He and I had talked extensively over the phone and he chose to believe in me and fight on my behalf. No one had done that since I left my first fellowship and started the second.
They say that when it rains, it pours. Around that time, another locum agent called me and got me a locum job in Ohio, and I didn’t have an Ohio license yet. It was also supposed to be a solo job, i.e. I was going to be the only pathologist at that hospital. That was a scary prospect, but I had wind beneath my wings, so I said yes.
I had been wasting away at home, in an unproductive state since April. To borrow from Gramsci, my old life was dying, and a new one was struggling to be born. I had been applying and interviewing at many places, both for locum and permanent jobs. I had been offered a job in Virginia Beach even before we arrived in California, and once I reached out, they still had the job open and were willing to take me on full-time. But my wife didn’t want to settle in the area, even temporarily, so I had to say “No” to that place a second time. There were locum opportunities for which I interviewed in Johnstown and Doylestown, both in Pennsylvania, that never went beyond introductions. There was a preliminary job interview at a practice in Seattle, Washington. Another in Reno, Nevada. Nothing came out of either of these. I was so desperate that I even applied to the VA hospital in Pittsburgh. I had even applied for medicine-adjacent jobs like scribe at a clinic, or associate at a dental clinic, or working at a grocery store.
The interim three weeks in July flew by quite fast. We took two pre-planned family trips, I filled innumerable forms for the job assignment, and I took my son to the zoo. The day I was leaving, I took three flights from California to Michigan. The last one (and the shortest) was delayed by five hours, so I was stuck at Chicago O’Hare. I arrived at my destination around 9 pm that night, close to 11 hours after leaving home. I had insisted on booking the flights on a Saturday, so I got one day to unpack and relax before starting work.
The Philadelphia recruiter eventually got me in touch with the facility’s head of department. After a couple phone interviews in late July, I was called in for an in-person job interview. I flew from Michigan to Philadelphia in the middle to August for the interview. I thought it went well. But once someone from the facility called my last fellowship program, my chances went south. It took almost a month of back and forth until I was told that they won’t be offering me the job.
Another opportunity was in Central New Jersey, where I flew for an interview mid-September. I drove from Newark to Red Hook, and had interviews at four different hospitals, one of them as far south as Brick Township. During my last interview, with the chair of the program, he told me that he wasn’t even hiring. He had just hired two new people and was expecting a retirement in the mid to near future. That was infuriating and I left with a bad taste in my mouth. The only solace was that I got to visit the beautiful town of Red Hook.
Also around mid-September, just before my trip to New Jersey, I had a virtual interview for a permanent job near Chicago. They liked me, I liked them. They offered me the job soon after. I visited Chicago three different times during my Michigan stint, and during my last visit, I went over to the practice and found them reasonable. I told them I was ready to join. The barrage of paperwork that involves permanent hiring started soon afterwards.
The locum job in Michigan was new and exciting, and quite challenging. I also had to do gross dissections, which was not my favorite thing during residency, but I had done enough to get by easily. My now-colleague, who had objected to my inexperience, was happy to have me there, once he realized that I could handle things by myself. (Apparently, they had hired a locum before me, a senior guy, who could not even operate the computer. That was where I came in.) Outside of work was a different story. I went to work, came back to my hotel room, rinse, repeat, ad infinitum. It was a small town in central Michigan, with not much to do. The only worthwhile thing I did there was attend a touring performance of ‘The Book of Mormon’ near the end of September. For all else, I either had to drive somewhere in Michigan, or fly to Chicago. I was very lonely. I tried resuming therapy but the online platform I used, didn’t find any providers in their network who were Michigan-based.
On the locum side, I got an opportunity to apply for a place in northern Indiana, near South Bend/Notre Dame. They paid better than the Michigan job and I wouldn’t have to do gross dissections. They also had a couple people working there already. It was an easy ‘Yes’. Meanwhile, the Ohio thing never panned out because my license didn’t arrive, and after some harsh truths I told them over the phone, the locum agent cancelled my contract. Once my two-month stint was over in Michigan, I went to Indiana for three months (with intermittent weeks at home in California).
I got paid for my first few weeks of locum at the end of August, the first time I had been paid since early April.
The same locum agent who had gotten me the Indiana job (Jay), dangled another opportunity for some of the intervening weeks in north Texas. I had to think about that one, but took it eventually. At the beginning of November 2024, I had an ongoing locum position in Indiana, a short-term (with possibility of long-term) position in Texas, and a potential permanent job near Chicago. Things were looking on the up. Until most of it came crashing down.
I was home during the first week of November and voted in the federal election for the first time. DT’s win was definitely a shock. That Thursday, I was about to board a flight to Texas for my first stint there that I got a missed call and voicemail from a Chicago number. I called them back and found out that it was the practice that I had signed a contract with. They told me that there were some issues with the hospital credentialing process and it didn’t look like I would get credentialed there (Translation for non-medical folk: It meant the job was off the table). I was on the phone while standing in line to board the aircraft. The three hour flight after that was agonizing. The Chicago dream wasn’t over it, but it had come very close.
I was in Denison, Texas, for only two days. Denison is a small town an hour or so north of Dallas, close to the Oklahoma border. My first day of this locum was quite uneventful. The other two pathologists were both very experienced, and vocalized how grateful they were to have me on board. On day two, I finally heard from one of the people at the Chicago practice that my job offer was definitely being rescinded. The chair of that program didn’t have to decency to contact me about it, and I had to learn from someone else. The same evening, I was scheduled to fly back to California, before I flew to Indiana a couple days later. My original flight from Dallas got cancelled (happens often, Dallas is one of the worst airports in the U.S.). As an alternative, I could leave on an earlier flight, which I chose. I communicated this to the pathologists there, one of whom told me to get as much work done as I could, and leave the rest for him. That is what I did.
I barely made it to the airport on time, because of general Dallas traffic and rush hour. I was probably the last person on board. That evening, on my way from the airport, I texted someone I had known for a long time, about their whereabouts and what they were up to. That conversation led me to a place where I’m permanently working now.
Back to second weekend of November. I was supposed to fly to Dallas, and from there to Indiana. My flight to Dallas kept getting delayed until it was not possible to make it to Indiana that day. I coordinated with the locum agency and rebooked my flight for the next morning. Once I was in Dallas, waiting for my next flight, I got a call from Jay, who told me that pathologists in Denison were upset with me that I had left work early and not finished everything before I left. I got on the phone with the guy who had told me to leave anything for him. His whole demeanor had changed, and he was not so happy with me now. I asked him for a second chance, to which he begrudgingly said yes. After those two days, I was supposed to go to that hospital again in early December, last week of December and possibly after.
The next day, I called Jay from Indiana, asking him if he could get me dates in January and February for the Denison place. He told me that they had cancelled my contract even for the rest of the year. Indiana didn’t need me after Christmas, and Denison was my potential replacement for early 2025. That left me almost in the same place as I was in July. I had no permanent job, and no locum job beyond December. I only worked seven days in December, just enough to pay the bills for a month. To borrow from Godfather III, “Just when I thought it was over, they pull me back in”.
