S8E12: Re(Designing) a Medical Career That Fits You

Hạ: I was going to talk about how three mini waffles cost more than four mini waffles at the General. That's how it works now.

Amber: They're incentivizing correct portion sizes, or I guess incorrect portion sizes. I don't know.

Hạ: Hello, dear listeners. Welcome to another episode of "Bundle of Hers." This is Hạ right now speaking, and I'm very excited to lead this episode today.

As you may or may not know, I am a third-year pediatric resident this year, and that means that for a lot of us, it's either you go to fellowship or you get your first big adult job, as considered in medicine.

And as I've been going through this whole process, there's been a lot of thinking, a lot of . . . Maybe I am making them appear as obstacles, but a lot of confusion and a lot of obstacles. The whole process has really forced me to reflect a lot on myself and my values.

And so I felt that that really did align with what this season has been about, which is the theme of growth through challenge. So the topic for this discussion, this episode today, is to focus about redefining your career.

Before we actually start talking about this, I want to first put in the caveat that the views of me and the other people on this episode today don't represent our respective institutions.

So all to say is the reason why trying to go through the job process, for a bit of context for people who might not be familiar with the U.S. medical system or are still pre-medical students who are listening, is that once you decide on medical school, a lot of times it feels like everything is pre-written for you.

After you get through pre-clinicals, then you do clinicals, and then you decide on what specialty you want to do. Is it pediatrics? Do you want to be a surgeon? You apply for that, and that feels like a really big decision. We have spoken about it before in a number of different episodes.

But when you make that decision, it feels really much like, "I have set myself for life," which is not true. Some people change their minds and do other specialties, but it does feel like this big turning-point decision.

Then you go into residency, and you realize there are so many other options, and the path that you have isn't as prescriptive as it used to be before. There's a lot of decision-making that you have to do and have to reflect on. So the path isn't quite prescriptive.

One of the big decision points that you do have to make, though, is trying to decide between, "Do I continue to do additional training?" especially if you're in pediatrics as a fellowship, like if you want to be a pediatric cardiologist or not, or, "Do I want to get a job?"

And so I would like to first introduce one of our guests who is on here today, Emilee. Emilee is one of the senior residents, a year above me when I started residency, and she is now working as a pediatric hospitalist in the Bay Area, working also with BMT and oncology.

I would love to hear you describe a little bit about how you went through that whole process about thinking between fellowship versus working.

Emilee: What you were saying kind of really resonated with me about how the first big decision you make out of residency is so hard because it's so much less prescriptive than the rest of the medical journey.

At least in the U.S., you kind of know what your life is going to look like, for better or for worse, for the next eight years or something like that through med school and residency.

I think both a challenge and maybe also a good thing is that I could have been happy doing a number of things, and then it became really more of an existential kind of values-based evaluation of what I wanted to do at that moment, and knowing that I could always do something else. But that was kind of a new feeling for me.

And so I came into residency thinking I was going to do an oncology fellowship. So I was going to do a pediatrics residency and then an oncology fellowship. I've always really loved the field of oncology. I've loved that patient population. I've loved the medicine behind it.

I still think I would have been really happy doing a fellowship in oncology, but then you kind of weigh other life reasons, including less exciting but real things such as opportunity cost, salary, time spent, and things that I think are ingrained in us as things that shouldn't really weigh into your career decisions. But as you extend your training, you are sort of trading away hours of your life.

And so I discovered other areas that kind of overlapped with my interest in oncology, and I actually became really interested in pain and palliative care, thought I wanted to do a palliative fellowship, and actually went as far as applying for a palliative fellowship, but found the process of fellowship application to be so much acutely more existential than I thought.

In that process, after interviewing, kind of decided that this was not the moment for me to do the fellowship. And so then I applied for jobs and really wanted to kind of focus on one goal at a time in medicine while having more goals outside in my human life and really tried to prioritize those things.

So now I'm working as a hospitalist, and may do fellowship again later, may transition careers at some point, but right now, I'm really enjoying learning on my job and also getting some time outside of work to re-remember other parts of life that it had been less easy to pay attention to during training.

Hạ: Really, having to do more training on top of the training that we already do feels like a really big lift, and it often feels like a lot of energy. And sometimes the training really . . . for me, I feel that it really burns you out, and sometimes you just want to have a little bit more space and time.

But I wanted to then introduce a person who did the flip side, who is going to be doing fellowship, palliative fellowship actually. It is one of my lovely co-residents who is basically a celebrity in our class, Josh. And he is going to be doing, as you might have guessed, a palliative fellowship now.

I would love to hear about his process because he also is a part of the primary care track in the residency and also really loves primary care too.

Josh: Yeah, I don't know about a celebrity. That's so much. I'm just some guy.

But it was very funny talking with you, Emilee, as you were making those decisions about palliative care, because I was also doing a lot of hemming and hawing between palliative care or primary care.

I came into residency and came into med school thinking what I wanted to do was to be a pediatrician and to be a primary care pediatrician. And I still really love primary care a lot, but I think in so many ways during residency, you're doing so many different jobs and seeing what it really feels like, when before residency it's always been much more brief the time that you're spending with the things that you think you want to do.

To an extent, it's still that in residency, but at least in residency, you're kind of doing it constantly, which is maybe not the ideal way to do that either.

But as I was going through that process of doing a lot more primary care than I had done in the past, realizing there were a lot of things about it that I loved, also I felt like, "Wow, I really just don't have enough time with these people. It doesn't feel like I'm able to do the kind of medicine that I want to do with the time I have allotted."

When you're running around with a 20-minute visit after 20-minute visit after 20-minute visit, I'm feeling like there's so much I want to cover and care for with you, and it just doesn't feel possible. And I found that really demoralizing.

I was looking for, when I was thinking about specialties, just things that gave me more time with people, with the people that I was caring for, I think because that's where a lot of the meaning in medicine came from for me.

And I think that led to me to some outpatient specialties that just give you more time with people and led me more towards inpatient things where your schedule during the day, to an extent, is a little more flexible, and you can kind of figure out, "Where do I want to allot this time?"

I'd had experiences with palliative care in my fourth year of medical school. I spent two weeks with them on a palliative care elective and found that time really beautiful for many reasons. I think probably a lot of the same reasons that you were drawn to the field too, Emilee.

I think why a lot of people enjoy interacting with the palliative care teams is that it's very whole-person medicine. You're thinking about the whole human in front of you, and that's initially what my goal was to want to bring to primary care. I found that really hard, and I was like, "Maybe I'm not good enough to bring that to primary care. Maybe I need to be doing that in a field where that's already all they talk about." And so that kind of led me to that.

And I think when I first encountered palliative care for myself as a med student, I had also been going through my own loss at the time. And so I felt very moved by the things I was learning, and I was like, "I can only imagine what this is like for these patients, and that feels like a really exciting thing to be able to be a part of."

And then just met a lot of different people working in palliative care through a lot of different avenues and had a lot of conversations, and eventually just told myself, "You know what? We're not going to know unless we do it."

Palliative care is a one-year fellowship and I was like, "Let's just see what it feels like." And I think even since matching, there's still been this kind of question that I feel like you were having too, Emilee, where it's like . . . It's very existential. "Was this the right thing to do?" But I'm just kind of saying, "Let's ride it out. We'll find out when it's over."

Hạ: In a lot of these conversations, the themes that are coming up are kind of balancing our own values against a system that often, even if we really love the work, sometimes doesn't allow us to do the work that we want to do. And also, kind of weighing the pros and cons of different positions and what we are willing to give away and what we want to prioritize a lot more.

As I've been sitting and thinking about things, it's really hard for . . . I'm a person who likes to say yes to everything and keep everything and not give anything up. That's why it's been really hard and a lot of personal exploration.

And as I've been trying to do this value exploration, there has been one person who I have talked with quite a bit about it since I was an intern, who was a lovely third-year resident, Amber. I was going to introduce what you are now doing, but Amber, I just realized I don't know anymore what you're doing. So you have to introduce that yourself.

Amber: Yes, I'm happy to fill it in because it does . . . I feel like it changes every few months or so.

I recently actually switched it up a little bit. So I am now doing 50% time that's fixed at the Children's Hospital of Oakland. In their emergency department, they have a section of it called the Annex or the Fast Track, which is essentially a part of the ED where patients will get triaged to when they're lower acuity. They're basically doing urgent care in the ED. So that's 50% of my time.

And then on top of that, I still moonlight at both the San Francisco General Hospital in their pediatric urgent care clinic, and kind of a separate, more in the privatized realm urgent care clinic. There's an after-hours clinic loosely associated with UCSF. So there, I do urgent care and also newborn baby visits. So that's kind of my little mixy-mix right now.

And yeah, I really loved hearing from you both, Emilee and Josh, about your journeys because I totally resonate with a lot of it. I think particularly this idea of recovering from the moral distress of residency. I don't think people prepared any of us enough before medical school, before residency, how much moral distress you have from just training.

Honestly, I attributed a lot of that to academia, a lot of that to the capitalistic way that the healthcare system functions and how hospitals need to crank out as much labor and as minimal pay as they can, especially for trainees. I think because of that and just a number of things, I wanted to distance myself from academia as much as possible after residency, so I kind of took a different approach.

I think a few people mentored me in this way of life of doing just moonlighting. So I know I just described how I have a 50% time commitment and then moonlight on top of that. Before this month, I was just moonlighting at four different places. It's a little non-traditional of a setup, but it really allowed me to take a step back.

I kind of used a design theory approach of if I took a blank slate and that is my life, how do I bring in things that I want to prioritize into that blank slate rather than the approach that I previously had of, "I'm a pediatrician. How do I center the life of a pediatrician in the middle and then build my life around that?" I think I had to decenter paid work and recenter what actually mattered to me.

It's always going to be worthwhile work no matter what phase of your life you're in to kind of go through that exercise. I don't know if I still even have it all figured out of what matters to me, what brings me fulfillment, what brings me joy, how I want to be stimulated. But I at least knew that if I gave myself some flexibility in my paid work, it would allow me the time to just explore the question of "Who am I and what matters to me, and how can I build that into my life?"

Josh: Yeah. And I love that you named the moral distress, Amber, because I feel like that was something that also pulled me so much towards palliative care. I felt like in the hospital, we were constantly seeing people who were going through horrible things. And then you were just like, "Well, I have five minutes this morning to check in and see how all your horrible symptoms are. And then I'm going to run to this next person, do the same thing, and do that back to back to back." It felt really bad.

I found that the times that I was with the palliative care team, when you actually got to be in that room and really get into it and talk about it with somebody, it reduced my moral distress a lot.

And a lot of people, I think, when they hear that I wanted to go into palliative care, they're like, "Wow, that is so sad." And I think for many reasons, I'm like, "Honestly, it feels a lot better than a lot of the other stuff that I was doing." That's just me personally.

Amber: Totally.

Josh: But yeah, it's kind of crazy how little we prepare people for that moral distress that they'll experience.

And I think it's a theme that I hear a lot of people talk about as they think about what they want to do after residency. It's reckoning with that part of it. And I think, honestly, sometimes I'm shocked that palliative care exists as a field because of exactly some of the capitalistic stuff that you're talking about, where I'm like, "Wow, how do they allow us to go in and have this super long conversation?" But I'm sure there are going to be some things happening in the background that I learn about once I'm a fellow that explain how this is going on.

Emilee: It's cool to hear you guys both talk about how each of your individual decisions kind of stemmed from sort of trying to alleviate the moral distress of residency and training generally.

I think I was talking to one of my friends who's a current third-year resident right now about just . . . Because I think I was thinking that the moral distress was intrinsic to the job of medicine because of the way we've set up healthcare in this country, and of course exacerbated by the 80-hour workweeks of training. But I sort of imagined it to be built into whatever the system is that we've created.

And I've found that even in the six months from me graduating residency and I'm working 85% of full-time . . . which is 40% of residency hours or something like that. Don't check my math, but it's way less than residency hours.

My job is very academic right now. I'm existing in essentially the same system that I trained in, although with more of my time at the Oakland campus with different patient populations and things like that, but still very much in academia.

The amount of moral distress from just being an attending and being able to kind of spend your time the way you want to and also bend some rules in some ways, not totally follow things, or also just do the things that you think are correct and not have to do things because someone with a different authority told you to do so has actually helped my moral distress by so much.

There are still horrible things that we see in the hospital all the time, and there are still things where I'm really mad in the middle of my shift or at the end because I've just really had an unsuccessful conversation about maybe vaccinating a child who came in with respiratory failure, and maybe we could do something about it, but I'm really not getting through.

Also, it feels so different from residency. And so I think there are just so many ways to kind of go about distancing that training moral distress, either by time, like Josh said, or by, I guess, power or independence or by physically distancing yourself from institutions.

Amber: And I think that kind of goes back to really investing in understanding what your values are. I feel like that's going to be infused in whichever pathway you choose.

I think you both also touched on this idea that I've been reflecting on of sometimes people think that money, how much your salary might be, is the currency that should matter the most. But I almost feel like across the board, when you talk to people coming out of residency, the real currency is your time and how you spend that, how much you can accomplish in the time that you have, and doing that in a way that feels values-aligned. 

Emilee: A hundred percent. I feel like my top advice to the third-years is don't work 100% of the time if you don't have to, even in your first however much, and then you can go up on your time if you need. But it's such a privilege and luxury we didn't have in training.

And then also, Amber and I were part of a little track within our residency that did some amount of leadership reflecting and values reflecting. And a lot of what you were saying reminded me of some of the exercises that we had done with design thinking.

But I think one thing that really helped me with my decision paralysis was when we came into residency, we had to write a personal mission statement, which was supposedly the guiding light of what your decisions were going to be made out of.

And I think I wrote it as a homework assignment or whatever in a class and kind of forgot about it until third year when I was like, "Am I applying for a fellowship? Am I applying for jobs? What am I doing? Am I in medicine? Am I going to stay in academia?"

And then reading what intern me thought I wanted, and then I actually went back and read my residency applications and my med school application to be like, "What are the constants across this despite it all?" I think that was helpful to just see the things that were motivating me and continued throughout and how to align myself to them even when it felt a little bit farther.

Hạ: What I think makes residency so hard is you always feel like you're losing so much of yourself. I think for me, when I'm trying to figure out this job decision that I'm trying to make, part of the stressor is trying to figure out what the perfect job is where I won't lose myself anymore, because it feels like residency has taken away so much of it. But it is kind of continually helpful to continue to center and say, "Oh, these are the things that excite me, and I will to find a way to integrate it."

It's also really hard because in this day and age, along with the moral distress about the system, we think about it also politically too and how a lot of national and local policies impact the way that we want to practice our medicine and the things that we can do.

I've been thinking about it a lot, and it's funny because it's like when I'm mapping and trying to figure out, "What are the things that make me really happy and what are the things that bring value me?" there are these topics. And now I'm like, "Oh, I don't know if I'm able to even do that anymore and practice the medicine that I envisioned when I walked into med school and into residency."

But then again, I have to recenter to that very core that you are talking about, those values that go beyond even the specific tasks that you're doing, but really what you want to bring into medicine, how you want to walk into that patient room, and the time and space that you want to give them. Instead of just focusing on the medicine, actually asking about what they like to do and really getting to know them and their family, or really having more control over how you want to lead those conversations.

Amber: What you're saying kind of reminds me of a question I wanted to pose. It's something I've been reflecting on a lot since residency, but I think one thing that can be challenging to navigate when you envision what your career might look like is what skills you want to hold on to and what skills you're okay letting go.

I'm curious how you all have kind of been thinking about this, because I do feel like in residency you do learn how to be a true generalist. You're learning all these inpatient skills, these outpatient skills, these highly specialized perspectives. You're learning bread and butter. You're learning rare conditions. When I've been thinking about how to piece together the things that bring me fulfillment, it was really hard for me to come to acceptance around letting go of certain skills.

For example, I was moonlighting in the pediatric ICU last year every now and then, the PICU. And recently, when I took this 50% commitment to the Children's Hospital of Oakland, I basically had to let go of moonlighting in some of these inpatient spaces.

I have made my peace with that, mostly because my last shift in the PICU was terrible, and I don't want to do that again. I was like, "I don't think I can even really understand right now how I'm going to weave this into my practice, so I'm okay with that."

But I've also been thinking about skills in the sense of even though I'm letting go of certain skills that I had in residency, I am also very intentionally using my time to build the skills that I want to build.

I think we all get exposed to so many different things in residency, but we might not always have the time to do a deep dive. So I've been trying to get certified to be an interpreter for medical Spanish. I am doing a lactation training right now so that I can be more equipped to help our newborn parents.

And because I had so many random days off, I was able to go do a day-long LARC training in Sacramento. So I learned how to place IUDs and Nexplanons, because we don't really get enough of that in pediatrics. I'm also getting trained to do medical evaluations for people applying for refugee or asylum status because there's a unique clinic that serves that population here.

And then also I've been trying to gain more skills in what's called street medic work. I know that, Emilee, you're bringing this didactic to the residency, but I've been thinking about just medical skills that I can refine that really allow me to work with the populations I want to work with and in the settings that I want to work with.

Especially, Hạ, to your point of the current climate, the current political climate, I think us as medical folks can really pivot and build the skills that we want to, even if it might not be expected for you to have that certain skill, for example.

Emilee: Can I just retweet everything you just said? Amber, you've always been someone that I feel like has such clarity, even when maybe it doesn't feel like you do. And one thing I feel like you do really well, and Hạ, you too, is bringing in other aspects of your life and being intentional about all of the things that you're spending your time doing.

I think even though I had so many qualms about the evils of academia and staying adjacent to it, I actually chose to stay in academia because it was the place that allowed me to give up the fewest things.

My time is so fragmented. I am working across five different settings, with some of my time being only 7% in some of the settings. And so I think this is a question I've really been thinking a lot about as we're going into thinking about what next year will look like. That's, of course, shaped by kind of the politics of what is even available.

And I'm just so grateful to have an inpatient job to begin with, but I think my first thing that I chose to give up was my newborn resuscitation skills, which I think is a big commodity for inpatient medicine because so much of it is well-baby and deliveries.

Keeping those up, those are really kind of high-stress situations. And I was really torn about, "Should I go to some community hospitals to keep up my delivery skills that I feel like I actually . . ." For all that it's worth, I think our residency does train us very well in deliveries, if not other things.

Amber: A little too well.

Emilee: Yeah, I feel very comfortable with NRP, which is neonatal resuscitation. And I was also like, "This does not bring me any joy, and I am okay giving that up."

However, things I have not yet given up are . . . I have oncology time as an oncology hospitalist. I work across two different campuses.

And then the other thing that I actually have built into my time a little bit is some education time, which is kind of what, Amber, you were alluding to, in trying to help the residency structure, how we bring an advocacy curriculum to the residents, which has its limitations being delivered in the context of the institution and a very rigid residency schedule.

But I think I actually could follow your example a little bit better, Amber, and think a little bit more about how to weave a narrative of what kind of person and doctor I want to be, and be okay giving up more of the things in exchange for being actually . . .

Even though I think both of us are technically generalists in that we didn't do a fellowship to be subspecialized, I think what you're describing is essentially assembling your own fellowship to have the depth of a subspecialist as a generalist.

Josh: Yeah, that makes so much sense. And I think something I heard in what both of you said, and Emilee, you said specifically, is talking about the neonatal resuscitation and being like, "This does not bring me joy." I think that's something I was thinking about a lot, the things that bring us joy.

Obviously, it's your job. You are working. We're not going to all be like, "Yay, I'm so excited to be here," 100% of the time, but you also want there to be some parts of it that feed you in some way.

And I think that was something I was thinking about a lot as I was going through the interview process for palliative fellowship, because I was struggling a lot with . . . I don't know. You're in your primary care clinic, and you have a really good day, and you have all your primary care preceptors who are like, "You're really good at primary care. You should keep doing primary care." And they mean it in the most well-meaning way, but also, I'm in the primary care track, and I felt super torn up about, "What am I going to do?"

And so a lot of my time in the interview season was spent thinking about splitting time in that way, between doing primary care and doing palliative care. Because something that brought me joy way was also seeing really healthy, happy, silly little kids, and I was like, "This is really fun."

I liked having some of that more generalist knowledge for these really common things that happen with young kids who are in many ways healthier than kids who are in the hospital, even though they have their own problems going on.

I think conversations that I had with a lot of people that I think were interesting in some ways was just people saying . . . A lot of times, people start out with all these different things, and then as their career goes on, they find themselves subtracting more and more and then ending up at this one thing.

And what I was thinking to myself was, "I guess I'll just subtract now and see how badly I miss it." I was like, "Let me get ahead of myself in 20 years or something." And this is someone who has yet to even start the fellowship, so I have no idea if that was the right decision or what decisions I'm going to make once fellowship is over about what career I want to do after that. But it was just an interesting thing that I've been thinking about in that way.

I guess part of where I landed also was . . . And this is very specifically for primary care. I was like, "Well, my friends will have kids. I can be their pediatrician." Just on the side, not their actual pediatrician. It's just like, "Ask me questions. Send me a picture of a rash. Let me keep my memory up."

But yeah, I don't know. That was just kind of a thought that I had while you two were talking.

Hạ: I was also going to say the other . . . because I am a person who likes to do everything and anything, and I actually need a punch card to say no to things. All to say is another thing that I was even trying to think about, which you did kind of allude to, Josh, is this idea of also temporality.

One of the things is when we decided on specialties, it felt like I was locked in for life. But what I have been realizing as I've been looking into career decision-making is that everyone who's been advising me has been going, "Just think about something that you want to do for the next three to five years."

There is so much range and so much ability to move, which is why I really like, Amber, how you think about building skills. These next three to five years of our lives can be used to kind of . . . I try to center it. Sometimes I still freak out, but I try to center that I can use these next three to five years to continue to gain the skills or the things that I want to be to eventually reach the type of doctor that I want to be. It's that mission statement that I had when I was a doe-eyed, dewy-eyed, whatever that term is, first-year med student with dreams.

Emilee, I feel like you have something profound to say.

Emilee: Oh, no. Never anything profound. I was just going to say that a lot of times I feel and/or these limits have been imposed upon us that you have to pick this one option and it has no flexibility in it. I don't know. I think you can do a palliative fellowship and practice part-time palliative care and do other things, which, Josh, you will be excellent in all of the things, in any of the things, if it's all palliative or all primary care or some other third thing.

I think it's similar where you will still have those skills that you gained in your palliative fellowship to be an even more amazing communicator and symptom manager in that year.

And I feel like it feels so, "Well, I'm locking myself into this career," but we can afford to be a little bit more imaginative about what we do after each thing, even if people are like, "Why did you do this fellowship and then not go into it?" But there are definitely people who do. I don't know. I kind of like learning things.

But I think one thing that has been helpful and kind of re-emphasized to me across residency was the concept of whatever radical imagination means to you.

It can be when I'm feeling extra stuck and extra like, "Oh, gosh, I have so much pressure to make these conversations," to really try to strip away all of the things I think I know are true and then be like, "If I could actually make XYZ happen, what are the things? And am I actually trying to get these things from work, or can I get them from somewhere else in my life? What are all of my goals? And where do I want to get them from? Can I get them from organizing with the community? Can I get them from volunteering somewhere? Does it have to come from my job?" That's something that I'm sort of also trying to build right now.

Amber: I mean, I would push that even further. Can I budget in time to go see my friend who lives in New York? Is that what's going to help me bring my full self back to work? I feel like hobbies, dude. There's light at the end of the tunnel so that you can have time to do things that don't even have to be moving you forward professionally, but moving you forward as a human being with multiple needs and multiple dimensions.

Josh: Yeah, 100%. It turns out we're people outside of our jobs. Crazy thought.

Amber: Wild concept.

Josh: I feel like that's something I also thought about too. I think a lot of the people that I talked to who went into palliative care were also like, "I felt like it gave me a chance."

I think something you mentioned earlier, Emilee, is something we neglect to think about. How much your life changes after residency is over too? But I think a few of the younger people who more recently went into palliative care that I talked to while I was making my decisions were like, "There were lots of things I loved about it, and it felt like it was something that would encourage me to continue to be a human being in a way that other things didn't feel like." And that was a nice thing to hear. 

But I also wanted to say I feel like part of the reason it also appealed to me is I felt in a way you could still be a bit of a generalist because, like you said, Emilee, these are skills you can apply in so many different contexts.

And hearing about all the stuff that you've been doing, Amber, that is all so cool. I think we're all people who are like, "I do want to keep learning things. These things are important to me, and I want to be able to serve communities in these ways, and so I want to have these skills."

And I think having that flexibility in our thought of doing all the things to help other people and also creating our careers in a way that gives us time to care for ourselves too is so important.

I think it becomes more and more top of mind the closer and closer we get to this career search and as we go through it, because it's not just something you get to when it ends.

I feel like, like you said, Hạ, with temporality, no decision is forever. You're iterating on this thing to get to a place that makes you happy for the time being. And then if that's going to change as the needs that you have change over time, you're going to keep changing what you do, as much as we're lucky enough to be able to do that.

Hạ: So beautifully stated. Retweet, reshare, repost, all of it. But yeah, I think this is why I love having conversations with you all, because I sometimes feel like in my brain it is chaos and there's fire all around me and I'm holding my cup of coffee, like that little dog in that meme. But when I talk with you all, I feel like, "Yes, I do have a sense of things, and there are ways to move forward."

I feel like thinking about how we can push what values mean for us as we define a career, or what does it mean when we say we are looking for a job, and what a career means, and as Emilee said, being imaginative and going beyond what the system tells us to do, just being able to think about it in all of those ways is so helpful. It makes my heart feel warm.

People can't see because we're voice, but Emilee gave me a heart. I just want people to know that. When I get a heart from people like Emilee, Amber, or Josh, it always feels like, "Yes, I won. I got my gold star."

So with all of that, I would like to close this episode. I really appreciate Emilee, Amber, and Josh for joining in and giving time in their very busy schedules to chat with me.

And for our dear listeners, I hope as you're listening to this you can continue to reflect on what your values are. What are the things that you want to prioritize? What is most important to you as you're trying to figure out how to get through this scary thing called adulting?

We much appreciate you all. And as always, you can listen wherever you podcast or stream wherever you podcast, or . . . This is really awkward. Bye.