Every January in Berlin, my husband and I observe one of my favorite traditions. We dress up in our outdoorsiest clothing- Patagonia hoodies, North Face jackets, Columbia beanies, the works- and head over to the European Outdoor Film Tour (EOFT). EOFT is the best. It’s all the adrenaline of an outdoor adventure with none of the exertion. You just sit in a giant movie theater eating popcorn (actually lentil chips, it’s that kind of crowd) and watch fellow humans perform unbelievable feats of nature. Kayakers plunging down 100-foot waterfalls. A guy in remarkably short shorts running eighty kilometers a day for fifty-one days straight. A group of professional skiers sailing across treacherous, ice-encrusted seas for two weeks to ski the planet’s northernmost mountain range. The human equivalent of a flying squirrel skimming canyons at breakneck speeds.

Thrilling as these escapades are to watch, one thing becomes obvious very quickly. Humans have an unhealthy obsession with speed. We can’t seem to help ourselves. If there’s a way to get from one place to another, we’ll find it and then we’ll figure out how to do it faster. One method we’ve come up with is to strap planks to our feet and then look for the steepest mountains we can find to hurtle ourselves from. We call this skiing.

Europeans are completely obsessed with skiing. It may actually be a prerequisite for EU citizenship. So, this week, in our ongoing efforts to raise upstanding citizens, the family has undertaken a ski trip. We are by no means professional skiers, nor did we face fourteen days on icy seas to get here, but we did drive twelve hours in a packed minivan with three young children, so you tell me who’s braver.

Watching people of all ages and levels of ability make their way down the slopes, it struck me that skiing is more than just an opportunity to wear unreasonable shades of neon. It actually provides valuable insights into navigating our professional lives.

The best way down the mountain isn’t in a straight line.

You can always recognize experienced skiers by the graceful arcs they carve in the snow. They are constantly pivoting, shifting their weight, crisscrossing the slopes but ultimately staying on course.

In medicine, we are generally encouraged to plunge down the mountain in a straight line. For the vast majority of us, that line leads from medical school to residency to either outpatient or inpatient settings, perhaps with a fellowship in between. The highly structured and relatively insular nature of our training, combined with its rapid pace, means we have little experience pivoting and few opportunities to pause and gauge what lies to the left and right of our path.

One issue with this approach is that it doesn’t exactly lend itself to interruptions. When you’re racing down the hill at full speed there’s never a good time to hit the brakes. But reality dictates that many of us will face interruptions at some point. It may be having children, caretaking responsibilities, physical setbacks, or mental health challenges. Whatever their nature, these interruptions have a way of forcing us to pivot.

I’ve had to learn to pivot many times in the course of my career and I’m not going to pretend that it’s been all rainbows and unicorns. There’s no clear career model for those of us who have gone off the established track. Being forced to navigate a new path can feel isolating. It can be discouraging when we’re made to believe we’ve fallen behind. But while it hasn’t always been comfortable or easy, I’ve learned that it’s okay to pivot. In fact, I believe it’s an essential skill. We become more adept at navigating the terrain. We learn to be resourceful. We start to seek out role models that better represent how we want to structure our professional lives. We begin to see the whole mountain and not just the track we’ve been set on.

In a culture that glorifies speed, we’re conditioned to believe we must make it to our destination in record time. You’re allowed to question this belief.

Pivoting may look like leaving academic medicine for a community hospital position or vice versa. It may be going back and completing a fellowship many years out of residency or choosing to work in primary care rather than the subspecialty you trained in. It may even be transitioning to a non-clinical career path and exploring an entirely new set of opportunities to apply your skills.

Stop to look at a map of the slopes and you’ll find there are plenty of ways to reach the bottom of the mountain, even if it occasionally requires braving the more challenging slopes, taking an extra lift or moving laterally for a stretch.

Reaching the bottom is not the point.

It’s the strangest thing in skiing. You see people race down the slopes like their house is on fire and when they finally reach the bottom what do they do? They get right back on the lift and head to the top again. It’s almost as though getting to the bottom of the mountain wasn’t actually the point of the whole endeavor.

As we build our careers, we tend to believe once we’ve achieved certain milestones we will have arrived. Getting into medical school. Graduating from medical school. Getting into residency. Surviving residency. Passing the boards. Getting a spot in that coveted fellowship program. Completing fellowship. And so on.  

The arrival fallacy is the illusion that joy lies at a destination ahead. Achieving a goal is not like walking through a portal. You don’t magically become happier when you graduate, get promoted, or win an award.

Adam Grant

I have fallen prey to the arrival fallacy over and over again, but the longer I’m in this game, the more I realize there is no such thing as arriving. I’m not even sure I know the destination anymore. And I’m starting to be okay with that. It’s en route that new opportunities emerge, whether it’s the chance to master new skills, make new connections, or forge new paths.

We have to learn to find joy in making our way down the mountain. There will inevitably be stretches that challenge us. Conditions will not always be ideal. We may hit an icy patch or slip and lose a ski. But we shouldn’t be gritting our teeth all the way to the bottom. The magic happens while we are in motion. Why not enjoy the ride?

Know when to quit.

I’ve fallen off the anchor lift a dozen times. All in one sitting. It was during a period when I had switched from skiing to snowboarding, just like I’m doing with this metaphor now. Those of you familiar with snowboarding will know the horror that is the anchor lift. With every sudden jolt I tumbled off and every time I did, I would clench my teeth and grip my board, humiliated but all the more determined to make it to the top. The anchor lift would not get the best of me.

On my final attempt, I took a deep breath, strapped in my boot, and reached for the tether. As the lift started its ascent, I felt nothing but calm. The anchor lift jerked and jolted but I held my balance. Elated, I realized I was finally going to make it to the top of the lift. And just like that, I fell off again.

It was in that moment I recognized it was time to invest my energy elsewhere. I needed to find another mountain, preferably one with a chair lift. (Or switch back to skiing, which I eventually did.)

I’m going to say something unpopular here, so brace yourselves. There can be times in our professional lives when no amount of determination is going to make it work. Our culture of relentless positivity would have us believe that with enough grit and tenacity we can overcome anything. Aside from the fact that this isn’t necessarily true, the question we should be asking ourselves is: At what cost? Do we want to continue rolling the ball uphill indefinitely? Does this tolerance for suffering serve us or is it merely serving a flawed system?

As doctors, we develop a high threshold for discomfort. It comes with the territory: in the course of our training we learn to ignore our need for sleep, our need to pee, our need to eat at regular intervals. We see people in pain, we watch patients die, we get yelled at by frustrated families. This ability to suppress our discomfort does not always play out to our advantage.

Because of it, we tend to normalize subpar work environments. We may find ourselves accepting toxic work places, overtly aggressive communication styles, a lack of support from leadership, or insufficient resources to do our work effectively as simply another uncomfortable reality of our profession. Add to this the moral obligation we feel towards our patients, who we may feel we are abandoning by leaving.

In these scenarios, it’s important to remember that our time and our energy are finite resources. It is our responsibility to expend them wisely; pour them into one thing and they will not be available for another. By continuing to say yes to circumstances that keep us from living into our full potential we are saying no to the ones that will enable exactly that.

No one can tell you when the time has come to move on from your own personal anchor lift. But know this: giving up on something that no longer serves you does not equate to failure. It means choosing where your talents and motivation can be put to the highest and best use. It means recognizing your own value and deciding where to invest it so that others may fully benefit from your contributions.

Sometimes you need to find another mountain to hurtle yourself from.

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For those if you who ski (Europeans, I’m looking at you) what are your favorite skiing wisdoms? I want to know!