Fast forward another 2 years and I'm back in Chicago.  It seems that one post every few years is all I'm capable of these days.  Perhaps it takes at least 2 years before the valve in my brain needs to vent all the pent up crap that accumulates while being a doctor.


I went for the trifecta of change this time: new job, new city, new baby.  Well I wouldn't advise it, I'm not sure that this change was avoidable given the training/fellowship 3 year cycle.  I officially moved back to the suburbs where I grew up; it has taken some getting used to be surrounded by family again. There was something comforting about being hundreds of miles away; you had no obligation to attend the random family outings and it was always more of a big deal when you came back into town.  Now the pop-ins are abound and every weekend involves a family obligation. It is nice to have regular social contact, Lord knows it wasn't always present in the ATL, but it can be overwhelming when you don't feel like you have time and space to yourself.


And really that leads into the next biggest part about living in the suburbs: homeownership.  Condo life was easier. We had a loft which was more or less a large concrete box.  It was idiot proof when it came to repairs and fairly easy to maintain and clean. There was no fear of some hidden lead pipe as all the pipes were exposed. No worry about rickety stairs, plaster walls or outmoded electrical. Now enter the 1930s home.  Behind every fixture is a time capsule of electricity in eras gone by.  Pipes in the basement are wrapped in newspaper to prevent freezing.  We appear to be supporting a small ecosystem of drain flies, silver fish and spiders. Lawns need to be mowed.  Outdoor lights turned on and off nightly. Lead pain concerns. Window replacement.  You name it - it's on the list. In attempting to have our stairs refinished and handrail secured we have to get quotes from no less than 3 contractors: a wood floor refinisher, a handrail refinisher and a stair carpenter.  FYI it's ridiculously expensive to get these things fixed.


Don't get me wrong, owning your own home where you can make all the noise you want and not have to share any common walls with neighbors has been great. I now have a place for all my tools in the basement and don't have to shove anything into a closet. While I might not have a neighbor 6 inches behind a common wall, actual home-owning neighbors has been a whole new interesting experience. When you live in the city, especially in a condo, the age range of other owners tends to be pretty narrow. Moreover people largely keep to themselves. There may not have been a welcome committee when we moved in, but there also wasn't anyone going all Rear Window and watching our every move. Many of my neighbors are now separated in age from me and my wife by decades. Many are also retired or work from home. They have all been incredibly friendly and helpful but you find that you can't really be outside your house without someone else taking note. Sprinkler on too long? You'll get a message from the neighbors.  Stroller left outside? Neighbors remind you to take it in.  Want to sit on your sun porch?  Neighbors will pop over to chat.  They watch all the service people come into the house. They comment on the products you carry in and out of the house.  Should a service person step off your lawn onto theirs?  You'll probably hear something about it.  I miss the anonymity that comes along with city living.  You could be sitting 2 feet away from someone at the pool and not say a word; glorious. 


I started a new job which was really the main reason for moving back to Chicago.  And I use 'Chicago' loosely as I'm firmly live in the suburbs and work in a further away suburb.  Overall I think my choice to leave academia to join a private practice was a good one. Gone are the silly demands for research and the idiotic hierarchy. It's replaced by RVUs and networking. My practice had tasked me with setting up a new office in a new suburb.  It has huge potential but it has become increasingly isolating.  We have had a lot of challenges in terms of getting another physician to join me this far away from the city.  It turns out people in their 30s aren't ready to commit to moving away from River North quite yet. As a result I drive 30 minutes to a windowless office only to hang out with PCPs all of whom are at least 20 years my senior. Work is still slowly ramping up so I have a lot of downtime, but I still have had a lot of trouble being productive. It's almost like a failure to mentally commit to where I am. I haven't hung up any diplomas, certifications or awards.  Frankly I don't feel comfortable with all my important documents being stored 30 minutes away in an unlocked office. But part of it is that it still all doesn't feel real.  There's some hardcore imposter syndrome going on every time my paycheck is deposited.  When you work for peanuts at the bottom of the totem pole for 10 years moving up a rung feels unreal.


Fatherhood, I am learning, is something you cannot prepare for. There are ups and downs. It is all time consuming.  When my baby cries and I can't seem to comfort him I feel helpless, scared, and frustrated all at the same time.  I feel equally concerned on a regular basis that I'm not doing enough to stimulate his mental growth. That somehow he will suffer because I'm not around enough or I'm not doing more.  I don't know how my parents did it without going insane with three of us. 


Overall I'm starting to ask myself questions that I though were only reserved for mid-life crises.  What is my purpose? How can I feel fulfilled in life? I always thought that the pitting sense of unease I had in the depths of my stomach were related to constantly being stuck in the gears of training. That once I had a career, home, family I would feel settled.  Instead it has been the exact opposite. Maybe it's just the way I'm wired. While sometimes I wonder if being a stay at home dad, or having a less stressful career would wash away these worries I know deep down inside that they would just be replaced by other concerns. Ugh. I sum it up with the conclusion that adulthood is hard and the adage that youth is wasted on the young.


And with that I conclude this three year update. Who knows, will it happen again in 2019, 2020?