There’s no quick fix for a hole it took years to dig

On a call with a client the other day, she dropped a line that I haven’t stopped thinking about.

She’s a physical therapist—I’ll call her Chrissy. She’s been in practice for 20 years. And she’s tired. Exhausted. 

She told me she wanted out, but also she had no idea what to do next. Did she want to stay in corporate PT? Start her own practice? Leave the bedside care?

I started describing how I work with clients to get them out of burnout. It takes eight weeks, I told her. In that time, we tackle some very big questions.

She took a deep breath.

“I was hoping there was just an antibiotic I could take for 10 days, and it would all get better.”

Noah Wyle never wanted to do another medical show.

The star of the ER, the show that launched the entire medical drama genre, refused to take a single medical role for fifteen years after the series ended in 2009. 

“I wouldn’t take a script if it was to play a doctor, even if it was a veterinarian,” he says. “The idea of putting a stethoscope around my neck just seemed like a really bad idea.”

And then Covid happened. To quote his 2025 interview with Variety:

As the world was just starting to retreat into lockdown in 2020, Wyle began getting DMs on Instagram from first responders overwhelmed by the first lethal waves of COVID-19. Some simply thanked Wyle for inspiring them to pursue a medical career with his performance on “ER.” But most of the messages were laced with an unmistakable desperation about the precarious state of the country’s health care workers — and how no one was telling their story.

“They were saying things like, ‘Carter, where are you?’” he says. “‘It’s really hard out here.’”

Wyle, meanwhile, was confronting his own pandemic-fed crisis…. “I just thought the world was coming apart. I didn’t know how to contribute anything of meaning or value anymore.”

And so The Pitt was born.

According to the National Center for Health Workforce Analysis, we’re recruiting new doctors just fine. The number of medical school entrants has increased nearly 6% since 2019:

By comparison, the US population has grown by only about 1.8% in that time. So, medical school recruitments are outstripping population growth.

And yet.

The US is projected to be short nearly 200,000 healthcare professionals in the next 10 years. That’s despite recruiting tons of new medical students.

What’s happening?

Well, imagine an old pipe. It’s faithfully carried water from a reservoir to your house for decades, making sure your sink works, your shower has enough pressure, your kids have water to drink, and your shower has the pressure it needs.

Over the decades, it’s started to show its wear… 

A year ago, a friend of mine took a senior leadership position at an NGO he’d admired for years. I’ve known Christiaan (not his real name) for at least a decade—he’s a soft-spoken, gentle, diplomatic Dutch guy. So, when I asked how it was going, I expected an equally diplomatic description of his new job in response. 

I got something altogether different instead. His answer was firm, immediate, and direct:

“Honestly, Mark, I love it. The best part is that my CEO sets the vision clearly, gives me everything I need, and then trusts me to get it done.”

Which got me thinking about the CEO we each have in our heads…Does that CEO trust us to “get it done”?

On the face of it, wellness programs sound awesome — resilience, well-being, work-life integration, and fostering growth of the person as a whole .

But wellness programs don’t work — at least, not in the way that increases actual physician wellness. 

What they do instead is keep physicians indentured to the system that burns them out in the first place. 

I sat at the airport café table, my flat white untouched, staring at my phone. I thumbed my passport absent-mindedly. The choices I'd made to get me to JFK that day felt heavy. What if I moved and hated it? Worse, what if I didn't move? What if I stayed put and resented never trying?

What was I supposed to do with all the potential regret? Could I really YOLO my way through life?

Can you?

Early in residency, doctors learn an important rule about working in a hospital: The longer you stay, the longer you stay.

In other words, the longer you stay at the hospital, the more work will be assigned to you, which, in turn, leads you to staying even longer. 

And that’s true in jobs, too.

But Job Lock doesn’t have to be permanent…

The whole scene reminded her of the humans in Wall-E, slouched in their hover-chairs, Food-in-a-Cup in their right hands, and limpid smiles on their rotund faces. It was almost like she'd unwittingly made a left-hand turn on a Tuesday in 2016, and she'd been shopping at the same grocery store for the nine years since; like she didn't exactly pick this direction, but here she was, gliding forward anyway.

You've felt it too, right? The gravitational pull of a professional identity you chose (or had chosen for you) long before you understood what it meant, long before your pre-frontal cortex was even a glimmer in your midbrain's eye.

I did. My friend Margaret did. She always knew she was going to be a doctor. The daughter of two physicians, she deeply admired her mother. At age 6, she confidently declared she'd be following in her parents' footsteps. And she did. A prestigious university, a top-tier medical school in New York City, residency and fellowship at the top hospital in the US, where she then rose through the ranks as faculty.

And she felt empty.

For those people in identity professions, transition often comes with a familiar dysequilibrium: 'I’m good at this, and I hate it.'

Research shows that our calling can evolve alongside the work we do. A surgeon’s precision may find new expression in process optimization, just as another’s quick decision-making can find new life in algorithm development.

Calling isn’t a cage—it’s a compass. Identity isn’t fixed. It flows, carrying your values into ever-changing contexts.

We've all got that friend. The one who's decisive as hell in part of his life-but couldn't choose a salad dressing if that life depended on it.

Let's talk about that friend, because not only is their way of living a fascinating peek under the hoods of our brains, but it also exposes one of the subtle ways our brains keep us stuck in the status quo.

Being a surgeon was my identity. For five years, ninja warrior had also become an identity.

Now that I no longer did those, who was I without them?

If you’re using pro-con lists to make big decisions, it’s no wonder you’re stuck. Using them is a little like trying to take out someone’s tonsils with hernia instruments.

Read on for what you should be doing instead!

Ever felt that nagging sensation that it's time for a career change, even when everything looks perfect on paper? Your instincts aren't wrong; they're backed by neuroscience.

Through the lens of Construal Level Theory, this blog post dive into why career transitions feel so impossibly difficult: your brain literally processes near-term and long-term futures in fundamentally different ways.

Drawing from both cutting-edge psychological research and real-world emergency medicine experiences, you'll discover why traditional decision-making tools fail during career transitions, and how to transform this cognitive tension into your greatest advantage.

Learn the Temporal Distance Mapping technique - a framework that bridges the gap between abstract career aspirations and concrete next steps. Whether you're contemplating a bold career pivot or seeking to understand your decision paralysis, this evidence-based guide transforms complex neuroscience into actionable insights.

Stop fighting your brain's natural wiring and start using it to make career decisions with unprecedented clarity and confidence.

A simple, seven-step framework I’ve developed to do make the hardest decisions in life with confidence. It comes from the principles of decision science, a field I’ve spent all my research life in.

And it’s deeply personal: I’ve used it myself to make literally hundreds of life decisions—from jobs to relationships to moving to new cities.

My hands look steady. They place each suture where it’s supposed to go. They thankfully don’t betray me when the scrub nurse puts scissors in them. 

Inside, my chest is crushed in a vice. My breathing is shallow. And my brain roils worse than a ship in the Bay of Biscay.

That day, my patient’s face wide open on the operating table in front of me, I learned to love fear, failure, and anxiety.

You feeling the holiday overwhelm yet?

Yeah. Me too.

It gets worse at the holidays, that nagging sensation that important tasks are slipping through the cracks... because your mind is so dang full of unfinished business.

The emails. The work tasks. The holiday shopping. Everything you've got to get done before the new year!

Let’s dig into the fascinating neuroscience behind this—and how to use it to hack your own mental performance

I know exactly when I ruined my life.

A touch overdramatic, yeah, but stick with me, because this story — about a single moment in Singapore 27 years ago — might also explain why you’re stuck in a job you hate, why you’re still living in a city that doesn’t set your soul on fire, or why you haven’t started that business or written that book or launched that podcast.

You made six choices today that weren’t even yours. Someone else pulled the strings, and you didn’t even know it.