Vacations are a way to get away – in every way. Yet in today’s hyperconnected, hyperkinetic modern world, it is more difficult than ever to disconnect, decelerate and rejuvenate. Our two-week family vacation was strategically planned by my lovely wife to allow rejuvenation of mental energies away from work concerns near the end of summer, including long stretches in the car; in remote rural areas; and being out the country – in part, to discourage on-line time. The 24/7 maw of the social media world that is drawing us into a Borg-like meta-community has a gravitational pull into its growing sphere of influence. Disentangling from it has become the primary challenge for a successful vacation.
Academic physicians seem evolutionarily conditioned to have our attention swallowed up by the immediacy of our daily work lives. Our nervous systems seem finely-tuned to reflexively respond to our daily sensory input of general need. At work, we are confronted with the “emergencies of the moment” that consume our carefully planned schedules. For me, this includes urgent emails from my boss, cell phone texts from mentees needing deadline-driven feedback on a paper, voicemails from professional groups on sudden changes to upcoming conference calls, faculty members unexpectedly out for personal reasons needing coverage, or a page from a nursing home on an immediate patient concern. The amygdala-jarring, guilt-reflex that each of these inputs ignites, reinforced by years of professional acculturation demanding immediate responses to all needs, makes ignoring them genetically impossible. Adding the barrage of input from overseeing a section in a department of medicine at a large academic institution (read: middle management) only raises the cortisol levels further. It is no wonder why, among academic physicians, burnout and turnover are so high.
Sometimes the only way to break the cycle is to eliminate the sensory input. Everyone I told that I was going on an extended vacation enthusiastically encouraged me to “avoid all work-related activities”. Easier said than done!
I was excited about our planned trip, even with the prospect of being locked in a car with my Eveready-bunny young boys for hours on end. When I was a kid, we would jump in the old Datsun station wagon and drive to grandma’s house, twelve good hours of complete family immersion and outer-world isolation. Playing “counting cows” and finding state license plates are over. In our car, there are three smart phones, three tablet computers, and 2 regular computers, all internet-connection compatible. Perhaps the one advantage of my cell-phone service with Sprint is the relatively poor coverage it provides in non-urban areas and the ghastly charges they have for international service. Even worse, having identified “internet access” lying at the very base of Maslow’s hierarchy of needs, every place you stop along the way provides WiFi services. It’s truly amazing watching people wander slowly about public places, slack-jawed staring at a phone, bumping into things. In protest, I carry a book around with me everywhere, sitting and reading something in the open periods available. Like other addicts, I spent hours each day in a cold sweat, trying not to connect my nervous system into the Matrix, slowly weaning myself off the electronic juice. At the beginning of the trip, I wasn’t sure two weeks would be enough time.
Everything triggered a reflexive need to connect. In reading a rest stop sign on the local history of Rome, NY – was it really the starting point for the building of the Erie Canal? In seeing someone wearing a LeBron James jersey in Cleveland – how were the FIBA team practices going? Had we heard back from anyone on our journal articles, especially the one to the Health Affairs Blog? Slow, deep breaths…count to ten…ask someone a question…read your book… This was work! When did vacation become such hard work?!?
Recognizing the challenge ahead, my wife had brilliantly planned for us to spend many hours a healthy distance from the Matrix. First, living cozily in a small, rustic two-story motel on Old Orchard Beach — a lovely, genuinely historic locale inhabited primarily by thin, smoking French-speakers from Quebec. Meandering a mile barefooted down the silica, confronted by the sine-wave eternity of sandy saline, is a wonderful psychic purgatory. We spent the first part of the trip at a local joint, catching an unexpected glimpse of a favorite celebrity, and hanging out with the bride and groom, moves the electronic buzz into the hazy periphery. Being forced to stop at a local gas station, all gussied up, to get directions to the ceremony at “The Barn at Flanagan Farm” from a woman with a knowing smile, because the GPS won’t connect, injects a healthy dose of humanity. Spending the day-after brunch with across-the-country friends you’ve only interacted with on Facebook in over 20 years, and discussing foreign policy among the wild flowers with an intensity social media precludes, reconnects the vivid present to the unseen future through the past. Hiking up a mountain, along sheer ravines with my adventurous sons, calves aflame, unable to send a reassuring text to my wife, calls forth a focus of intensity to block out the world. Staring through the cool, swirling mist of pulverized water on rock from the deck of a boat staring up at Niagra’s relentless falls, unable to snap pictures with your smart phone, forces you to simply enjoy the moment. Exciting the senses and calming the soul.
As the sensory apparatus was revived by salty ocean breezes, fresh seafood, bright wild flowers, prickly briars, and cool mist, the cognitive gears began turning again. Freed from the character confines of Twitter chatter, narratives of new friends emerged. Shared struggles up a steep, rocky mountain invited bonding discussions of oceanside views. Meeting Ricki inside her beachside Place, quicky, discombobulated bookstore/motel/knick-knack/beach-equipment rental encouraged bibliophile bonding, and some more books for the collection. Open enjoyment of a new marriage in a field of clover led to wide-ranging discussions of the entrepreneurial spirit altering the landscape of international relations. Touring the Joshua Chamberlain museum, some more pieces of history clicked into place, as the WWII-vet docent filled in more details. And another Civil War history book went into the collection. Stopping at the Fort Erie historical site, engagingly led by a young local woman in period clothing, and punctuated by the firing of a mortar shell ordered by my son, I could almost feel the neurons reignite.
As the vacation flowed along, as my senses revived, as my brain engaged, I found the need to write creatively emerging. Using my long-dormant blog, I spent time each night piecing my thoughts together, gratified to find others who shared my thoughts. Why was I so intrigued by professor-turned-soldier Joshua Chamberlain? What did I enjoy so much about used book stores? Why was I found myself feeling happier than I have for some time, enjoying the simple vitality of being alive, letting my inner self choose the topic, rather than responding to the “emergency of the day”.
I finally had some space and energy to contemplate – to, as Dr. Suess would say, “think about thinks”. The true value of an extended vacation is less to get away from things like the matrix, but to get close to one’s inner self. The “getting away” is really just the first part, to clear the playing field, to blow out the engine, to pull the plug on the tub full of dirty water. Or like a beach after high tide, when all the sand sculptures have been melted down, and the canvas again lies pristine. Once that’s done, one can really get to work, focusing all of one’s energy on the creative task at hand. I now feel like I imagine my kids do when they start on the new sandcastle or master a new skill, happily creating something anew from nothing, investing all of one’s ample energy in the project at hand.
I’m grateful to my wife for planning this vacation, finding a way to detach us from the persistent buzzing of our Web-ensnared devices, nudging us out into the wilderness of reality, allowing us to engage with the wider world. I’m thrilled that she was rewarded in many ways: recognizing a favorite sit-com star who flashed across her field of vision, re-engaging with an old friend at the wedding (both wearing beautiful lavender dresses), playing on the beach with her boys, and enjoying another birthday dinner with me. We’re now a little older, a bit wiser, and more thoughtful – and perhaps, a smidge happier.
 Yes, a pager. I suspect doctors are the only professional group that has failed to give up this antiquated, annoying form of communication. Mostly symbolic, like stethoscopes and white coats, that allow physicians to maintain a professional identity, to the detriment of job function.
 As we discovered during our recent trip to the Black Hills of South Dakota, Sprint has absolutely no interest in providing any cell service whatsoever in that area. They really ought to change this into a “feature” for vacationers like me, guaranteeing “absolutely no service, no matter the urgency of the matter”.