A Change is Gonna Come

Happy Monday, CR readers!

For the last week or so, I’ve been making references to a “seismic life change” in the works, and a few of you have probably noticed Twitter allusions to my “last editorial meeting” or various “goodbye emails.” It should therefore come as no surprise to any of you to hear that tomorrow will be my last day as a book editor, my job for the past six years. Today, I thought I’d share what I’ll be doing instead.

As all of you know, I’ve worked for the last two years as a clinical nutritionist who specializes in plant-based food coaching. I’ve loved the work, and feel confident that I’ve helped at least a few of my clients—many of whom are regular CR readers and commenters—to take lasting steps toward a more balanced and informed relationship with food. Most of the work I do with clients is psychological in nature, but much of it is prescriptive, too: I try to help my clients understand what a balanced day of food looks like, what his or her caloric and nutritive needs are, and how to prepare, store, and create food that will serve those needs.

I love my work, but it has a lot of limitations. One of the most frustration limitations is that I can’t always address health issues that go beyond the parameter of nutrition. Why? Because I’m not a medical doctor, and I don’t have that kind of expertise. This means I’ve often had to turn away clients who were looking for an answer to diabetes, thyroid disorders, endocrine disorders, cancer treatment, reproductive disorders (like PCOS), and other illnesses. As much as I have a working familiarity with such conditions, I can’t really offer prescriptive advice on how to treat them; I just don’t have the expertise.

I’ve found over the last two years that forcing myself only to focus solely on food and nutrition is often frustrating; I hate turning down people in need because I don’t have the knowledge to help them get better. And since I see nutrition as part of the much larger picture of human health (and vice versa—human health depends completely on proper nutrition), it’s difficult for me to talk about diet without wanting to deepen the scope of my advice, and talk about health more broadly. In short, I love what I do, but I’ve come to suspect that I won’t long be satisfied with its built in limitations. And it’s time for me to change that.

In January, I’ll be embarking on a long, difficult, and exciting transition from food into medicine. I’ll be starting a post-baccalaureate degree at Columbia University (my alma mater!) in pre-med studies; this is what you have to do if you want to be a doctor, but were too busy studying 19th century novels and poetry as an undergrad to take any pre-med classes. And after about a year and a half of course work, a summer of MCAT studies, and a “glide year,” I’ll be starting medical school, and the long process of becoming a doctor.

The idea of med school actually occurred to me over a year and a half ago. I had heard a friend mention that her younger sister was doing a post-bacc to go to med school, and I felt a pang of jealousy. I’ve never in my life envied anyone else’s career, but for the next few days I suffered from a persistent case of “I wish”: I wish I were younger, so that I wouldn’t have to start med school at what is (comparatively speaking) a ripe old age of 28; I wish I had known that I’d want a career in health when I was younger, so that I could have taken premed classes as an undergrad; I wish I had money, so that I could take on the necessary debt.

In the end, I decided to start exploring less expensive and time-consuming options than med school. I looked into getting an R.D., and enrolled in some of the pre-reqs for that track at night. (If you’ve ever wondered why I tend to complain about being busy, it’s because, for six months, I’ve been taking organic chem, anatomy and physiology, and statistics at night, in addition to writing my blog and counseling.) But I kept bumping into the fact that a lot of my interest is in GI health and disease, not dietetics.

A few months ago, M asked me why I’d never thought about med school, and I told him that I had, but that I’d dismissed the idea because of my age, the amount of time it would demand, and the debt I’d incur. I was surprised to hear him say that he didn’t think any of those things should stop me from doing it. If I didn’t really want to be a doctor, or if I really did want to be a dietician, he argued, that would be good enough reason not to pursue it; if I were adverse to hard work or long hours, that would be another good reason. But of course I’m not. What scared me—what still scares me—were money and time. With M’s gentle encouragement, the support of my friends and parents, and some good old fashioned soul searching, I decided that I shouldn’t let either money or my age stop me from what could be the most rewarding pursuit of my life.

To say that I’m anything less than terrified would be a lie. I’m terrified of everything: the debt, the difficulty of the work; being thrown back into student life; studying the sciences, which don’t come naturally to me, rather than the humanities, which do; leaving an industry that has nurtured me; sleep deprivation; commitment to a thirteen year education; the prospect of trying to have and raise a child in my thirties as I also battle med school and residency; and oh, did I mention the debt? It all terrifies me, and on a bad night lately it’s not unheard of for me to anxiously send out a desperate text message or email to a friend or two, asking him or her to remind me why I’m doing what I’m doing. (And they always do—thanks guys.) I’m so, so scared of what lies ahead.

But of course, I also know that this is a meaningful and exciting decision—probably the most daring I’ve ever made—and that if I can achieve even a small fraction of what I’d like to achieve with this education, it will have been worth every dollar and every hour of memorization, clinical rotation, and sleep deprivation.

What do I hope to achieve? First and most obviously, I’d like to help people who are sick or suffering to feel better, and—when I can—help them to actually get better. I’d like to place an emphasis on preventative care through diet and lifestyle. Finally, and most obviously, I hope to devote my entire career in medicine—whatever that may be—to fostering a mainstream, medical understanding of veganism. I’ve been lucky always to find doctors who supported my veganism (in part because I’m proactive in seeking them out), but I know others who haven’t been as lucky. Until more doctors are educated about veganism, there will remain a skepticism about vegan diets within the medical establishment. I want to help break this cycle, not only by using my education and knowledge to help patients who are interested transition responsibly into plant-based diets, but also by sharing my passion for veganism and my confidence in its benefits with other medical professionals.

In short, I want to bring my understanding of the vegan diet to medicine, and an understanding of medicine to my work as a vegan.

This means leaving my career as an editor behind, which makes me sadder and more conflicted than I can say. Many bloggers have written about how blogging helped them to ditch desk jobs they hated and pursue their true passions. This isn’t one of those stories. Tomorrow or later this week, I plan on writing a longer elaboration on my feelings about the publishing industry and what it means to leave it behind. But for now I’ll say that my life in publishing introduced me to some of the smartest and best people I will ever know, kept me intellectually challenged at every turn, taught me innumerable life lessons, and was in every way a worthy experience. I’m not trading a job I hate for one I love; I’m leaving behind a job I love very much for another job that I also love, but that feels more urgent to me right now.

I’m sure that many of you have questions about what this means for me and for CR. For example, will I still be blogging? Yes! I cannot wait to begin chronicling my adventures as a literary woman who’s been thrust into the world of science; to talk about the things I learn about the human body and its workings; to write about the turbulent intersections between mainstream medicine and traditional, holistic beliefs; and, most importantly, to write about what it means to be a vegan advocate within the medical establishment. CR isn’t going anywhere; in fact, one of the nice things about life as a student (as opposed to life as a student and a full time book editor) will be a little extra time to devote to my blog each day. I’ve never before had the time to make this blog a daily chronicle of my life; it’s intimate, but I’m not a diarist. Hopefully, life as a pre-med student and med student will grant me at least some time to reflect on daily experience—and to cook a lot of delicious food.

What about my counseling practice? For now, I’m sorry to say that I can’t take on any more clients. I wish I could, but school is going to devour my time–and that’s as it should be as I work toward this goal. Keep checking back, because I WILL take clients during my gap year!

Finally, you may be wondering what I intend to specialize in? Thankfully, I have quite a bit of time in which to figure that out. I could conceivably fall in love with neurosurgery or orthopedics alike. But I suspect strongly that my interest will in gastroenterology, for pretty obvious reasons. No matter what, nutritional counseling will be a significant part of what I do.

Right now, on the eve of my departure from FSG, I feel the predictable mix of emotions: fear, anxiety, excitement, exhilaration, and inspiration. Most of all, I feel gratitude to the people in my life who encouraged me not to shy away from this path because of the hardship involved (M, even with the ramen noodle and dumpster diving jokes, that means you). And I feel grateful for you, my blog readers, who have kept my interest in health so alive in the two years I’ve been writing CR. When I began blogging, I had no idea that health care would become, along with reading and writing, the defining passion of my life. You helped me to realize that, by stirring up long and fascinating conversations about health, by sharing your own healing journeys with me via comments and email, and by cheering me on as I broke into the nutrition field. Thank you for that. I hope I can ask you for the same kind of encouragement and support as I begin this challenging process. And hey: if any of my physician, med student, or post-bacc readers have (non-scary) advice to share with me, I’m all ears!

Thanks for letting me share the news, guys. It was hard to keep it under wraps in the last two months, and now that I’ve said the words aloud, I can’t wait to keep you involved with everything that lies ahead. I’ll be back throughout the coming week with more reflections on the end of this era of my professional life, some recipes, and some holiday cheer.


P.S. Columbia students! I’m about to join your ranks (again). If anyone’s interested in a meetup this winter once I’m settled, holler, and I’ll get around to setting it up.

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  1. I know I am very late here, but congratulations!! I have read a lot about the post bacc at Columbia and it sounds like a wonderful program (was thinking about doing something similar myself, but that’s on hold for now). We need many many more doctors that are passionate about preventative medicine and nutrition in general and I know that you will be a great promoter of both 🙂 So happy for you!!

  2. I’m a bit late coming to this post, but I just wanted to say that I find your passion inspiring.

    I have a humanities background – a degree in English & Political Science – and in the next 18 months I will complete my PhD in Online Culture Studies.

    However – science is calling my name so very loud.

    I really desperately want to study Nutrition (I’m not sure about the case in the States, but in Australia that’s a three-year undergrad degree) with an eye to completing a masters in Dietetics afterwards… or I want to study medicine. Like you, though, I am hesitant about starting my med school (5 yrs + practice) at the age of 29. I don’t know if I can take that risk – what happens if I don’t enjoy it, what happens if it’s not the right choice for me? – but I’m hoping the answers will present themselves to me over the next year or so.

    Good luck for your future in medicine.

  3. Gena –

    I’m so thrilled for you! Even though I haven’t read your blog for that long and I am not a vegetarian/vegan/raw foodist, I find it very inspiring. I’m incredibly pleased to hear of someone like you interested in joining the medicine professional and changing it from the inside out; you are truly planning on doing wonderful things! I’ve included a quote (and many might disagree with the person whom the quote is from) that I believe is very suited to you and this situation – as I can tell from the comments that you are already helping people look into themselves and realize that their dreams are, in fact, possible.

    “Show me your achievement and the knowledge will give me the courage for mine.” – Ayn Rand, from The Fountainhead

    You are an inspiration to all of us. Best of luck, you are going to do wonderfully!

  4. Hey Gena! I just found your blog not too long ago (actually just joined the blogging world myself!) and holy WOW you are such an inspiration!!! And a force to be reckoned with!!! Good for you for going out there and chasing your dreams. I am so happy that I have found your blog!

  5. I used to read your blog when you first started it, but had not read it in awhile, so I was surprised to come back and see that you are planning to do a postbac and apply to medical school. I know you’ve gotten a ton of congratulatory and exciting comments; I just want to give you a small dose of realism.

    I’m a neurologist; I went to med school (Mount Sinai in NYC) at age 24. I took 2 years off after college. I had always known I wanted to be a doctor; my father was a doctor and loved medicine. I enjoyed medical school for the most part. It really isn’t that hard; people will say it’s harder to get in than to flunk out, and that’s true. The tougher part comes later – residency, and the absolutely enormous personal sacrifice you will make. I did not get married until I was 32 (after I finished residency), and I had my first child at 35, after I finished my 2 year fellowship and became an attending. My personal life was completely on the back burner during my training because I had absolutely NO time for anything else. Yes, people do have children during residency, but now that I have a 9 month old baby, I don’t see how it is possible (unless you have a parent nearby to raise the child, or a stay-at-home husband). The debt you will incur is enormous. The financial gain is pretty meager. I went to medical school 10 years ago, and I have $130,000 in loans, which isn’t much compared to students today. My husband, also a physician, has a similar loan burden. It’s really, really tough. I’m not complaining, because we do make quite a bit of money at this point — but that’s after TEN YEARS of training and living on salaries of 40k a year, while seeing friends live normal lives of having kids, buying houses, making normal salaries, etc. It will be EXTREMELY difficult for you to go through this in your thirties.

    Also, it’s easy to have that wide-eyed wonderment about medicine, but once you start working on the wards, you’ll see that it isn’t all that it’s cracked up to be. Don’t get me wrong, I love my job, but almost everyone in medicine becomes bitter after dealing with patients who are hostile, unappreciative, and downright nasty. Doctors aren’t revered like they used to be. I try to teach my patients about healthy living, too (I’m very focused on health and exercise), but most don’t listen. It’s very, very difficult to change people.

    You have a very long, hard road ahead of you. You’re basically going to completely sacrifice your personal life for the next twelve years (2 years postbac, 4 years med school, likely 6 years residency + fellowship). I went into it not really thinking about the hardships and the fact that I was going to sacrifice having a family. Luckily I was able to get married and have a baby… if I were you, I would really think about whether this is what you want to do. As a sidenote, I was surprised you would choose traditional medicine after some of the earlier posts on your blog — I had often gotten the feeling that you were anti traditional medicine, and that was one reason I got turned off and stopped reading your blog. You may not agree with everything that you will learn in medical school. You WILL have to prescribe meds, birth control pills, etc. If you have philosophical issues with that, it might be a problem. Just something else to think about.

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