Somewhere between the kid who wanted to be a doctor and the physician you are now, something broke. A third of clinicians cannot even remember why they chose medicine, and the gap between the dream and the daily practice is where burnout settles in. Brian Sayers, a rheumatologist who has run an anonymous counseling program for almost 4,000 physician visits, argues that the way back starts with a 10-minute exercise most doctors have never done.

⏱️ Chapters:
0:00 Introduction
0:30 The two-doctor practice and the 4,000 physician visits behind this episode
2:50 Why every creation story matters, from couples to civilizations
4:46 The doctor's smock his mother sewed when he was six
5:36 The night a med student found his father's autopsy on his own ward
8:10 Why a third of physicians cannot remember why they chose medicine
9:55 Is "calling" just code for administrators exploiting doctors
11:10 The intentional practice that pulls you out of a frustrating day
12:52 Why complaining about medicine is the wrong role model for residents
14:31 The country doctor patient who became his patient 40 years later
16:00 Take home messages

About this episode:
Brian Sayers is a rheumatologist in Austin, Texas, who is about to mark 40 years in a privately owned, two-doctor practice. Eight years ago he founded an anonymous counseling program through his county medical society that has now funded almost 4,000 visits for colleagues, and he chairs a committee supporting physicians in recovery. In this episode, he argues that physicians lose their footing when they lose contact with their own origin story, the moment they first knew they wanted to be a doctor, and he shares his own: watching his alcoholic father die of liver disease when he was 12, then finding his father's autopsy report on microfilm as a third-year medical student at Parkland, on the same ward where he was caring for patients dying of the same disease. He pushes back on the idea that "calling" is just a word administrators use to extract more labor, defines it instead as the intersection of your gifts and what the world needs, and walks through what happens in the peer storytelling groups he runs when a third of physicians realize they cannot remember why they went into medicine. He closes with a concrete 10-minute exercise for any clinician who feels the gap between the doctor they wanted to be and the one their practice has made them.

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