An Examined Life

I wish I would have kept writing in here more often. I think it is good for me to get my thoughts out on in writing. It helps me clarify my thinking.
I have about a year left before I will need to decide where I am going to work. This causes me a lot of anxiety rather than excitement. I am excited that I will be done with residency and will finally be "beginning" my life. Yet I still don't know what I want to do with it--this causes me anxiety.
I chose emergency medicine because I really wanted to do something great but also have the flexibility to do something crazy/nontraditional.

Here is what I am seeing: Residents graduate, they get a job and they are now making a good salary. They buy a better car, a better house, and work the grind--waiting for their days off. They have kids, and their biggest stressor is whether to send their Kindergartener to a private $15,000 a year school or send him to public school. In the community practice, it isn't even about the interesting medicine anymore as it is during training, it is "moving the meat" and trying to get out of your shift on time--making sure your notes are complete for maximum billing.
It seems so UNFULFILLING.

Alternately, I went to a speaker on campus sponsored by the global health initiative which highlighted a physician who has been working in Ethiopia for the past 2o years with a catholic NGO. This man had done something incredible with his life. Picture after picture was of the children he had saved, or had improved their life significantly. Some he had adopted, others he worked to cure their cancer, get them a surgery, or provide just basic care. When he spoke he seemed truly happy, truly fulfilled. He was not rich, but lived a nice life. At the end of his career he could look back and think: "Wow, look at what I did with my life."

Then I think about me. Am I selfless enough to give up the salary/lifestyle here to do something so altruistic? Although is it true altruism--when I would likely get as much out of it as my patients? I have worked so hard to be able to make enough money to have a nice lifestyle where I can travel, have a house and a cabin, drive a nice car. Do I want to give that up? Am I that kind of person?

So what about what I am doing in the emergency department every day? Aren't I helping people? Yes, I suppose I am, but it doesn't feel that way. If I wasn't there, someone else would be. The system is in place. I dont NEED to be there. Being a physician in the US is almost automated...pt comes in with a chief complaint, I order tests, pt admitted. Normally very simple. If the patient didn't see me, they would see someone else. It is a rare day when I feel like I truly helped someone. But maybe I am just wanting more to life than there is.

Why am I always unsatisfied? Why do I always want more?
I didn't want a traditional marriage, I don't want to buy a house, I don't want to be tied down to one place, I am struggling with even having children. What am I afraid of? Normalcy, I guess.
Why do I want to travel--I want to go everywhere, I don't want to feel like I have missed out on something.
I don't want to look back with regrets. I only want to look forward with excitement. Is that too much to ask?