Another Hemisphere

It was Christmas Eve, which meant, as the resident non-practicing Jew, I was participating in the time-honored tradition of taking call. The emergency department was a cacophony of monitor beeps, phlegmy coughs, and sneaker squeaks – an orchestra of barely-contained chaos. My pager went off for what felt like the millionth time that night; Grandma had one too many eggnogs and fell down the stairs, splitting her scalp and scaring the grandkids. EMS delivered her gift-wrapped in gauze. Her toothless smile greeted me.

“Oh, thank the Lord for people like you,” she said, clutching my one free hand. 

She didn’t know it, but I had recently handed in my resignation, and this would be my last call shift. I felt my eyes rim with tears, which I blinked away as I set up my station and began her repair. I thanked my own God that she was chatty – telling me all about her three daughters, and their sons, especially the one who was a medical assistant, who had held pressure over her head until the ambulance arrived. She described her Christmas tree, and all of the gifts, and how this year they had been particularly frugal because she never thought she would make it to eighty-something, and money was running low.

I’ve always loved these interactions. When I was younger, I broke my parents’ cardinal rule against talking to strangers, endlessly curious about how people became who they are. I devoured memoirs and binged docuseries, vicariously experiencing lives I’d never live—eight billion unique paths, tangled in unpredictable choices. I’d never be a professional free diver, or migrant bused in from Texas, or a drifter hopping freight trains, but they had all been my patients, and I had the privilege to hear their stories in those small, magic in-between moments medicine offers.

Yet that night, I didn’t feel the normal delight of someone entrusting me with their literal and figurative life. I felt frayed. And dirty. And hollow. And beneath it all – nothing.

It was a death by a thousand papercuts. Not by one dramatic blow, but relentless, insidious erosion: purposefully public humiliation by a supervisor, new hospital protocols prioritizing liability over care, passive-aggressive evaluations leveraging “professionalism” concerns for admitting to burnout. The quiet threat beneath every interaction: You’re lucky to be here. Don’t act like you don’t want it.

Over those two years, my empathy calcified. I became suspicious of softness — in myself and in others. I no longer expected to feel proud of my work. I stopped believing this training would build me up to the person I sought to be. I was told it would be okay; it’s just one rotation, just one night, just one comment. If I made it through this – just put my head down and pushed through – I would be golden. But I started to look up to find I didn’t recognize or like who I was anymore.

Residency didn’t make me strong. 

It made me brittle. 

January 1st arrived like a quiet benediction. The day itself was unremarkable — dry, overcast, the kind of morning that forgets to assert itself. I woke early out of habit, half-reaching for a pager that wasn’t there. The absence startled me. In its place was stillness. I sat on the edge of the bed and let it wash over me; not elation, not even relief, but a kind of spaciousness I hadn’t known I was missing.

When I left, I did so quietly. No confessions over drinks, no big announcements. Some decisions feel too fragile to name aloud until they’ve been lived. Like early shoots of something green, they need space before standing up to scrutiny. So I let the silence carry it for me. I said things like “taking a break” or “thinking of reapplying,” even as I was applying for a visa, booking a one-way flight, finding a flat on the other side of the world. I slipped out of my life like someone backing down a hallway, careful not to wake the sleeping.

I arrived in Australia in July. The Sydney winter is gentler than I expected — blue skies, sharp winds, that peculiar southern sunlight which angles low but stretches long. The hospital is smaller, less industrial, and oddly less hostile. People say “no worries,” and mean it. There is no culture of guilt masquerading as grit. No prestige economy where every act is a transaction in the currency of worth. It’s still a hospital — fluorescent lights and charting systems and the soft hum of air conditioning that never turns off. But it’s one where doctors go home. Where a bad day doesn’t mean you’re a bad person. Where you can be wrong, and still be wanted.

It’s strange how little space it takes to begin healing. A proper lunch break. A balanced call schedule. A colleague who asks how you’re going and waits for the answer. There was no single moment of exhalation; instead, there was the slow return of bandwidth. For thought, for stillness, for noticing the wind shift on my walk to work.

I began to write again from some inner compulsion that had thawed. I wrote about the dissonance between what we’re told training will be and what it becomes, about the quiet grief of those who stay, and the more covert grief of those who leave. I wrote to remind myself I was still here. That medicine hadn’t swallowed me whole.

And still, the question trailed me: why?

Not just “Why Australia?” but “Why not stay?” “Why not stick it out?” “Why walk away from something so few get the chance to do?”

Because what they don't say -- not in white coat ceremonies or sub-intern welcome breakfasts or even in the midnight chaos of the emergency department on Christmas Eve — is that sometimes what looks like quitting is actually a redirection. A return.

The mythology of American training is thick with moralism. We suffer, therefore we are worthy. The longer the hours, the deeper the sacrifice, the purer the intention. To deviate is to diminish the sanctity of our field. But what if the moral failure isn’t in the leaving, but in the unquestioned staying? Australian medicine isn’t better, but it is honest in a way I hadn’t known to crave. It acknowledges that doctors are not gods. That deprivation is not a rite of passage. 

I think of all the residents I trained with in the States — brilliant, brave, tenacious people. I think of how many of them disappeared behind their own eyes. And how normal it was to watch them go. I couldn’t bear to be another one of the gone.

So I boarded a plane, crossing hemispheres and seasons, holding only this hope: that somewhere, I could still be both a doctor and a person. That hope turned out to be enough.

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