I remember going through an inventory of needs vs. wants about 10 years ago and deciding that my biggest need was for a drastic change in my professional life before my wants morphed me into some kind of stereotypical, high-earning, voraciously consuming North American Yuppie Boomer.

Well, here it is 10 years later and I’ve managed in the past 5 or 6 years to change my life to the point where I am a distinctly different-looking professional than the one I had been for the previous 28. I now do a lot of different medical work, my opinion seems to be valued, I generate way more money than I did previously at much less cost to my physical and mental health, and the company I own a fair chunk of is expanding its equity base and considered quite successful. I have more time to read, contemplate, procrastinate, and pontificate. I have a grown family, all of whom are successful in their chosen professions and who have decided to provide me with a growing cadre of attractive, bright grandchildren. I suppose this all could just be a normal evolution rather than a direct causal result of my decision to transmogrify into an alternate professional self, but without a properly designed RCT, I don’t think the question is anything besides moot.

However, when I took stock of all this stuff again today I discovered that really what I had accomplished over the past few years of needs gratification was just another way of filling up the wants basket without killing myself in the process. I’m pretty sure that this was not my intention at the start of all this 10 years ago but it certainly seems to be the result, and I have been wondering how it all happened.

Further reflection is always a good idea and after a fairly long episode of reflective pondering (my wife calls it daydreaming), I have a high degree of suspicion that basically all anyone wants (needs) is to be happy. All the hard work, all the mental gymnastics, all the quasi-business machinations, all the long-term planning, all the penny-pinching and bankbook finagling are a required and intimate part of each individual’s basic need to be happy.

So, obviously the decision to change my professional focus answered my most pressing need at the time. However, by taking that particular fork in the road, I inadvertently ended up with more time to devote to life in general, and now find myself owning a lot of stuff, all of which seems to make me quite happy. By definition, I suppose that I have become the thing I was trying to avoid becoming, but I’m not sure that it is all that bad. I find myself happy with my life. I love the work that I do and I have more time and resources to enjoy the remainder (and most important part) of my life. In fact, and I hate to admit it, I am a really happy, North American Boomer.

The point of all this is not to promulgate a wholesale exodus from the trenches of “real” medicine, but to point out that all anyone really wants is to be happy. The trick is in first recognizing this and then developing realistic strategies to satisfy one of our most basic needs as easily and as simply as possible. I have been around for a while now, and my sense is that if you only respond to the seductive whisper of your wants genie and ignore your much more important but less intrusive needs genie, the result is, more often than not, just the opposite of happy.

—JAW