It isn’t every day that I hear the phrase: “Mom, did you hear that YouTube video about a neurosurgeon who quits and moves to the mountains alone”? I had not, but a quick search of my Doximity curated feed led me straight to it. In this video a young male neurosurgeon, is sitting on a mountainside and tells his story about quitting neurosurgery after 10 years in practice. It has almost 10 million views!  I won’t go through all the details as perhaps you may want to watch it, but there isn’t much in there that surprised me. In fact, most of what he talks about resonates. He sees so many miserable patients with back pain that he can’t help, even if he does a “perfect” surgery. This leads him to question his purpose which he truly believes is to relieve suffering. Furthermore, he feels the system is stacked against him as if he recommends more effective holistic management, like dietary changes, exercise and sleep, both he and the hospital don’t make any money. This in his words leads to “moral injury”.

People think he is having a “mid-life crisis” but he doesn’t feel in crisis at all. In fact, since he quit, he is happier than he has ever been. Spoiler alert: it doesn’t sound like he has any debt; he has enough savings to live on and no children yet to support. So, his decision was less fraught but still, I’m sure left him feeling vulnerable.

The reason my daughter thought I might like this video was that I have, of late, had my own midlife “non-crisis” where I took a sabbatical from clinical neurosurgery. I feel very fortunate to be employed somewhere that supported this and up until it happened, I honestly had never even considered taking my foot off the gas.

The idea sprung from a meeting in Mazama, WA where there was an opportunity to participate in a neurosurgery teaching mission in Kathmandu, Nepal followed by a guided trek to Everest Base camp. Being the adventurer (in decline), I impulsively signed up for the following year. As the time came

closer, I realized that the logistics were going to be challenging. How was I going to take 3 weeks off to do this plus still attend all my regularly scheduled meeting travel and family commitments? A senior colleague reminded me that I was entitled to “Professional Development Leave” and after 14 years at Stanford the sum of time might be quite generous. So, I investigated it and decided to take three months “off”. Well, in normal neurosurgeon fashion, I filled that time quickly with courses, a Medical Humanities fellowship plus my Nepal adventure. Another bonus was that I had a meeting in Portugal and invited my parents. Following this meeting, my father and I walked 100 miles of the Camino Portuguese together.

So, I walked… a lot.  Almost 200 miles with a max height of 18,192 ft (5545m) when I reached the top of Kala Patthar (see picture with Everest in the background at sunrise). While I don’t believe I had reached the depths of despair felt by the young neurosurgeon in the Youtube video, I did need a re-set even though I had not fully recognized it.  What I would tell this neurosurgeon after my experience is that we do relieve suffering, but it may not always be in the obvious ways. Sometimes it is just by listening and acknowledging another’s experience. Outside of the neurosurgery patients I treated in Nepal, I ended up taking care of many fellow “trekkers” along the way with all types of ailments. From acute mountain sickness to pediatric dermatology and many things in between. I also listened to many who

had ended up in the mountains or on the roads of Portugal to give time and space to issues they were going through. I met a young female intensivist who in her first job and was struggling to gain the respect of her senior colleagues all while facing relationship problems at home.  She needed this walk to address her own “private turmoil”, she said.  When we parted, she thanked me for simply acknowledging her struggles as a female physician.

When I came home, I expected a mountain of problems in the clinic but overall, everyone was doing well – my patients, my colleagues who stepped up to cover me. Even my family did just fine without me I somewhat grudgingly admit.  I think the fear of what would happen if I did take my foot off the gas was so much worse than the reality.  So, I would offer an alternative solution to “moral injury”.
Remember that first we are physicians and healers, and we don’t always need to use our scalpel to accomplish this. Take the time to stretch yourself in a new direction, even if that might in the short-term hurt your bottom-line. Finally, it is a fact that we are all dispensable and the sky won’t fall if we step away temporarily to take in a different view. 

CANS President, Ciara Harraher and fellow trekker Alexander Nielsen. Nepal Spine Foundation Fundraising trek to Everest Base camp. April 2024. (Kala Patthar 18,519 ft or 5644m)