Most stories about doctors leaving medicine start with burnout. This one does not. Samantha Nazareth was a fulfilled gastroenterologist with a thriving solo practice in Manhattan when her mother died and she started asking whether medicine could be all of her. She booked a six-week sabbatical. Three and a half years and 90 countries later, she says the only thing she left was a windowless basement office.

⏱️ Chapters:
0:00 Introduction
1:43 Why she stopped waiting for retirement
3:02 The triple exit, and the only one people ask about
4:24 The six weeks that turned into six months
5:16 Why she posted nothing for a full year
8:39 How she paid for a sabbatical with no plan
9:59 Signing up for medicine at 17 and never questioning it
11:49 This was not burnout, so what was it
12:33 Do you coast on competency for the next 20 years
13:36 She could not swim, so she went and got scuba certified
19:30 Nobody talks about the middle of the leap
22:20 What she actually left was a windowless office
29:26 The one thing physicians need before they can leave
34:02 Take home messages

About this episode:
Samantha Nazareth signed up for an eight-year medical program as a teenager, trained in New York, and built a solo gastroenterology practice in Manhattan, which was the version of success she had been promised. When her mother died in 2021 after retiring into home hospice, the idea of waiting until retirement to live stopped making sense to her. She booked what she thought was a six-week sabbatical in Puerto Rico, and three and a half years later she has not returned to traditional practice. She is careful in this conversation to say it was not a burnout story, that medicine was never the villain, and that she was genuinely fulfilled. Her question was narrower and harder: can medicine be all of me, and do I coast on competency for the rest of my career? She talks about the parts nobody posts, including the year she stayed silent on social media because she believed everything was still reversible, learning to swim as an adult so she could pass a scuba certification test, mangling French badly enough that a story about an ant bite came out very wrong, and the daily uncertainty of not knowing what country she will be in next week. Her work did not disappear so much as move, into telehealth consulting and AI, and she describes what she actually walked away from as a windowless basement office with artificial lighting. Her advice for physicians eyeing the same path starts with solitude, and her closing message is to stay a student and learn something uncomfortable. Her memoir is I Left Anyway: The Life I Was Supposed to Want.

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