67: Pack Lighter - The Just-in-Case Workup & The Art of Carrying Less

First, I want to talk about the overpack, because I think we, in medicine, are world-class at it.

For the family that is experiencing the three milestone graduations over the course of two weeks, each one feels like an arrival.

We made it.

We're done.

And then, almost immediately, there's a new list, a bigger list, a harder list.

Kindergarten graduation doesn't mean you stop going to school.

It means first grade, now with something called homework.

The cap and gown aren't even hung in the closet yet, and the next packing list is already forming, That staircase is our whole training.

Medical school, residency, fellowship.

Each graduation feels like the summit, and each one is really just the gate to a bigger bag.

You walk across the stage, you take the photo, and the next list is already being written.

And training itself is the ultimate overpack.

We cram in everything.

The entire differential for things you will see twice a decade.

Every pathway, every exception, every zebra.

We carry the whole thing in.

And the honest truth is, most of it sits at the bottom of the bag.

You don't use the obscure stuff daily.

You just don't.

But every so often, and this is why you don't regret packing it, every so often the zebra walks in.

The thing you carried for years, the fact you were sure you'd never need, finally earns its spot in the bag.

It's got to be a pheochromocytoma this time.

Lysosomal storage disease, anyone? That one patient, that one save.

You don't pack the zebra because you'll use it often.

You pack it for the one time.