MEDICINE AND THE
UNEXPECTED: A LIFE AND
CAREER WITHOUT PLAN B
Scott Duncan, MD, MHA, FAAP
I
n the throes of my youth and adolescence,
I thought altruistically. I always wanted to
become a doctor. I considered being a missionary and treating the poor, and becoming
a heart surgeon. I learned to be concerned for
the welfare of others. I didn’t have a Plan B.
My father suggested that I join the military
to pay for my college degree; I politely declined. He suggested I stay home; I politely declined. He suggested
a large state–run institution; again, I politely declined. I learned
the advantage of personal attention and the joys of a cadre of close
friends at a small liberal arts university. There wasn’t a Plan B.
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learned how to be students and survivors. We didn’t have a Plan B.
After completing two years of basic sciences, I still had no career
plans and remained unfocused. During my junior clerkship in
Pediatrics, I spent two weeks in the Neonatal Intensive Care Unit
with a professor passionate about his work. I learned about clarity
and a life’s calling. I didn’t have a Plan B.
After residency, I completed a neonatology fellowship. But my
altruism had been shaken. I saw infants struggle to survive. I became
leery of the high-tech solutions at our disposal to prolong life. I
was disillusioned as a researcher. I needed a break from academic
medicine. I learned that a change of scenery often lends perspective.
I didn’t have a Plan B.
Before entering medical school, everyone asked, “What are you
going to do?” “What specialty are you going to choose?” I replied,
“I could never do Pediatrics,” but I really didn’t know what I was
going to do. I learned that uncertainty wasn’t a bad thing. I didn’t
have a Plan B.
Fresh from training, I soon recognized that my first position wasn’t
going to work long-term. I lined up a job near my hometown and
moved. I learned you can go home, but it’s never quite the same as
you remember it. There wasn’t a Plan B.
Many of my classmates and I found the transition from college
to medical school as a shock to the system. We struggled that first
semester. I found myself on the verge of failing coursework. We
The one