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Force #9: Honesty and Integrity. In this eight-part series, I have tried to name the forces that leave academic life pale and breathless: Bureaucracy, Metrics culture, Erosion of mentorship, Shrinking autonomy, and The quiet moral injury that comes when meaning is replaced by measurement. But epilogues are not meant to repeat the diagnosis. They are meant to point to something concrete. A symbol  that reveals the deeper pattern. For me, one such symbol is this: A public veter

Force #8: Reclaiming purpose. After weeks of writing about loss, I found myself asking a simple question: Is this just nostalgia? Am I merely longing for a past that can’t return? It’s an easy trap. Especially for those of us who have been around long enough to remember different eras, different rhythms, different ways of working. But I don’t think that’s what this is. This isn’t about going backward. It’s about remembering what mattered, and choosing, deliberately, to protec

Force #7: When values and reality diverge. There is a kind of tiredness that sleep does not fix. It isn’t physical. It isn’t even emotional. It sits somewhere deeper. In the place where your values live. I have seen it in the faces of good people. Not burned out. Not cynical. Just… disappointed . As though something they once believed in has quietly let them down. We talk a great deal about burnout in academic medicine. Burnout sounds clinical. Manageable. Like something you

Force #6: The disappearance of apprenticeship . There are things you learn from books. And there are things you only learn standing beside someone. How to feel the difference between a tense abdomen and a painful one. How to enter a stall quietly so a nervous horse doesn’t startle. How to pause - just long enough - before speaking to a worried owner. No textbook teaches that pause. Someone shows you. And you carry it for the rest of your life. When I think back to my own fo

I have come to think of life not as a long road, but as a series of T-intersections. For long stretches, we travel forward assuming the road continues indefinitely. We settle into rhythm. We grow comfortable with direction. We tell ourselves that this is simply how things will be. Then, without warning, the road ends. There is no straight ahead. Only left or right. And no going back. If you hesitate too long, you hit the wall. The Difficulty of Blind Choices What makes these

Force #5: Counting what’s easy instead of what matters. A few years ago, after giving what I thought was a particularly good lecture - the kind where the room leans forward, where the questions keep coming, where you can almost feel understanding settle into place - I walked back to my office feeling quietly satisfied. Not proud. Just content. It had felt like teaching. Real teaching. Later that week, my annual review arrived. Pages of numbers. Clinical productivity. Relative

Force #4: Decisions made far from the clinic floor. There was a time in academic medicine when most decisions were made within earshot. You walked down the hall. You knocked on the department chair’s door, or the hospital administrator’s door if it was a clinical issue. You talked it through. A new piece of equipment. A schedule change. A clinical protocol. A hire. It wasn’t perfect, but it was human. Decisions were made by the people closest to the work. The people who under

After doing a book reading of my latest children’s picture book, Bin Chicken Abroad , to a 5th grade class, I received thank you letters from each of the kids I had read to. This is one of them: It mentions that I am   perceived as  cool . In fact, it suggests that I may be the coolest . A word from my generation. I was struck by the use of this word by a twelve-year-old. The letter itself is full of everything one hopes for when visiting a classroom. Enthusiasm, sincerity, a

I remember the moment the valley opened. We had been climbing through the Andes all morning, the road tracing ridges where clouds brushed the hillsides and the air smelled clean enough to drink. The land felt ancient and patient. Terraces, scattered farms, eucalyptus leaning into the wind. Then, as we descended, the color changed. At first it was only a glint. Pale rectangles catching the sun. I thought they were ponds, or frost. But around the next bend the truth came into f

After a snowfall in a city, the planners’ intentions briefly become visible. Sidewalks form tidy lines. Crosswalks sit where they were designed to be. The grid asserts itself. But within hours, something else appears. A narrow trench cut through a snowbank. A diagonal track across a lawn. A faint dirt line branching from the official path. Urban planners call these desire paths . The unofficial routes people create when the prescribed one does not quite work. They emerge slow

There are moments in public policy when science quietly accumulates in the background for decades, until suddenly it must step forward and speak with a single voice. In the United States, the Endangerment Finding  was one of those moments. Most people outside environmental law have never heard of it. Yet it sits at the foundation of modern U.S. climate policy, shaping regulations on cars, power plants, methane emissions, and industrial pollution. Without it, much of the feder

Force #3: The quadruple mandate. There is a particular look I have started to recognize in young faculty. It isn’t incompetence. It isn’t indifference. It certainly isn’t lack of commitment. It’s fatigue. Not the ordinary kind. Not the end-of-a-long-week kind that a good night’s sleep fixes. Something deeper. A thinning of spirit. As though the light that brought them into academia in the first place has quietly dimmed. Early in my career, exhaustion usually meant one thing:

Force #2: Administrative drag. Not many years ago, I tried to hire a young neurologist. Bright. Capable. Thoughtful with students. The sort of clinician you recognize immediately. The type who listens carefully before speaking and whose patients seem calmer simply because she is in the room. She wanted to teach. She wanted to build a program. She wanted an academic life. We lost her. Not to salary. Not to a competing offer. We lost her to time. By the time the position descri

Force #1: Financial disparity with private practice There is an easy explanation for the thinning corridors of academia. Money. It is the first thing everyone says, often with a shrug, as if the matter were settled. Of course, they leave. They can earn twice as much in private practice. And it’s true. A boarded neurologist, surgeon, or internist can step out of a university clinic on Friday and, by Monday morning, double - sometimes triple - their salary in specialty practice

When I first visited India 10 years ago, veterinary care felt deeply local. A single veterinarian. A modest clinic. A hand-painted sign. Perhaps a ceiling fan turning slowly above an exam table. Medicine lived close to the community. Today, something more complex is forming. The pet food boom has created momentum, and momentum attracts capital. What begins with kibble rarely ends there. India’s pet market is now drawing two very different forces at once: Global nutrition comp

Until recently, dogs in India ate what families ate. A ladle of rice. Lentils. Chapati ends. Perhaps a splash of milk. Food was shared, not purchased. It came from the kitchen, not a factory. But walk through any modern Indian city today - Bengaluru, Mumbai, Delhi, Hyderabad - and you begin to see something new. Brightly colored sacks of kibble stacked beside soap powders and cooking oil. Pet supplements in pharmacies. Grooming products delivered by app within the hour. Quiet

Last week I read that National Veterinary Associates (NVA) had banned elective declaw procedures across its 1,400 hospitals. My first reaction was simple: Well done NVA! Declawing has always troubled me. Removing the distal phalanx of each digit for “convenience” never sat comfortably beside the oath most of us took to relieve suffering. If fewer cats undergo that surgery, that is almost certainly a humane step forward. But my second reaction lingered longer. Not about the pr

I am prompted to write this essay following a recent article in the Sacramento Business Journal announcing a $120 million gift to the UC Davis School of Veterinary Medicine. According to the university, $80 million of the gift will fund a new small-animal teaching hospital as part of the school’s $750 million Veterinary Medical Complex expansion. UC Davis said its existing veterinary hospital treats about 50,000 patients annually. The expansion is expected to allow care for u

These Words Are Not Interchangeable. Veterinary medicine relies on language not only to describe what we see, but to shape how we think. Few word choices reveal this more clearly than the casual substitution of disease , disorder , and syndrome . They are often used as if they mean the same thing. They do not. To veterinarians, these distinctions matter because they guide diagnosis, investigation, treatment, and prognosis. To clients, they matter because each word carries a d

Some terminology problems in veterinary medicine are obvious. Others are so familiar that they disappear into the background. The way we describe limb location   - front , back , fore , hind  - falls squarely into the second category. These words are convenient. They feel intuitive. They are widely understood. They are also anatomically weak . Why this distinction matters In veterinary medicine, language does more than describe position. It encodes: Developmental origin, Skel