On The Road Again

On the road again
Goin’ places that I’ve never been
Seein’ things that I may never see again,
And I can’t wait to get on the road again.  Willie Nelson


If someone had told me even ten years ago that I would retire young and become an itinerant radiation oncologist I would have thought he had lost his mind.  As the career medical director of community based cancer centers, I was used to running the show.  And as the saying goes, I ran a “tight ship.”  Consultations were performed and documented in a timely fashion, day of the request if the situation was urgent, or within a few days if not.  The patients were given time to think about their treatment, but simulations could be done the same day as the consultation, or as soon as the patient agreed to treatment, and the new start times were never more than a week away. Patients were seen every week, or more frequently if needed.  I had the best team of radiation therapists, physicists, nurses and front office people that anyone could ever ask for.  But in early 2014, I like to say I retired.  But the truth is, I quit.

Articles about physician burnout are legion, and I have avoided adding to that literature in this blog. The truth of the matter is that we, as radiation oncologists, are a very privileged group.  We are privy to the most intimate details of our patients’ lives; we practice in a highly technical and ever changing environment which challenges us to be constant and consistent learners; our hours are regular and we are very well paid as a medical specialty.  And most importantly, we cure cancer.  What could be better?  But after thirty years in the field, I was tired.  2013 was a terrible year for me—in December of 2012 I lost a close friend, Catherine, and then my little dog Jack, and then in January my mother, and shortly after that my work partner Dr. William Spanos, the best colleague and friend a physician could ever hope for.  And in between, some very beloved patients who I had followed and treated for years.  I was done.

But a calling is a calling, and somehow, between the enchanted mountains of New Mexico and the healing hours spent on horseback and with my dogs, and the otherworldly sunsets and the pleasures of growing a vegetable garden, I needed to get back to doing what I do best—helping cancer patients.  So here I am, a “locum tenens” radiation oncologist, working for an agency, going where I am needed, for a few days, or a few weeks at a time.  On Sunday night I “saddled up” the old Suburban and headed to Las Cruces, NM to provide a little relief to the solo practitioner stationed there.

Today I saw an elderly woman who had just been diagnosed with locally advanced and metastatic lung cancer.  Despite the effects of her disease—weight loss, shortness of breath and pain—I could see that she had been and still is a beautiful woman.  I can’t cure her—no one can.  But I could promise her that I could make her breathing a little easier, and relieve the painful metastases in her lumbar spine. As I sat with the patient and her husband, I knew with certainty that I no longer had to be “in charge” or command my own practice.  I knew that I could help her.  And I knew, beyond question, that I had begun to love my profession again. For that I am very grateful.


  1. Remembering the joy that caring for people and helping them in anyway that bring them comfort or peacefullness as well as trying to cure them is a blessing. It is the reason providers and caregivers came into the profession and why we stay. Sometimes we have to take a break to heal and show ourselves compassion to return and do the same for otbers. Congratulations.

  2. Oh Miranda,
    What an amazing woman you are. I love the choice you made, and the care with which you assist people to heal, or die more easily.
    Thank you, on behalf of every one of them.

  3. I burned out VERY early on in my career as a veterinarian and left clinical practice to stand on a racetrack and watch horses (I was paid for this – it was lucky that they closed the racetrack 3.5 years later because it would have been hard to walk away from that cushy, dead-end job!).

    So I turned to being a relief veterinarian (locum tenens) and found my niche. I’m good at what I do. I can drop into a strange clinic and get along with the staff and practice good medicine and take good care of the clients and patients. The vets who hire me are are grateful for thier time off and the help that I give them.

    I never know quite when I will work but I make nearly double what I would make as an employee vet AND I have far more time off.

    It takes courage to step out of an established routine. But the rewards can be tremendous.

  4. Even charcoal can still catch fire. So happy to hear you are once again sharing your warmth and expertise while helping patients find some ease to their pain and fear.

  5. Wasn’t expecting this post! You go, girl! (Er, Doctor.) Not only did you give me a bit of hope, but also, the women commenting are seeing and showing me a little light up there that probably isn’t a train.

  6. Beautiful! I am glad you follow the calling. I quit a very unpleasant and stressful job April 29; still trying to find my calling. You are an incredible woman and I enjoy learning your story. Blessed be

  7. There’s no shoe like an old shoe- Last week, I found an old, forgotten, and slightly used pair of navy blue Chuck Taylors (Converse Hi-Tops) in the back of my closet, and life hasn’t been the same since. Now, they love me at the bank, the convenience store, the supermarket, and even the library. Why? Because $200 running shoes are everywhere, I can stop on a dime and give you nine cents change, and most of all because I love myself again. That’s not illegal in Pennsylvania, is it?

  8. Beautiful story. It was burnout that caused my decision to leave radiation oncology six years ago and it is my love of patients and oncology nursing that assured I didn’t leave permanently. After three years in another part-time job working with breast cancer patients in a women’s center, I found myself back in radiation oncology with the same coworkers. Now I work on my own schedule, only about four days a month which is perfect for me. Knowing what a great physician you are, I can’t imagine you not working at all. You are wonderful with both patients and staff.
    Next year I’ll celebrate my seventieth birthday. Who knows how long I will last…

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