It takes onions to examine our core values

On our soul-searching journey of "52,” each of us might ponder the tough question, "Who am I?" For me, that’s a particularly difficult task because, in order to try to become the best "finished product" that I can, I must think continually about what I value most, then try to integrate my often-conflicting answers into the whole. 
There’s an onion metaphor that I like, one which suggests that each of us has a core of key values with layers spreading out in descending importance.  Beginning at my core, I, for example, see myself as some synthesis of father, teacher, husband, neighbor, uncle, student, and so on.  Throughout the coming year, we can peel back various layers of our onion (hopefully, if you''ll pardon the old witticism, without shedding too many tears in the process) to examine them more closely and find a way to rank their significance.  Today, feedback from an editorial of mine that appeared this month in the medical literature has led me to focus on the onion layer that represents my professional persona.
For many of us, our career is a core layer of our onion. Often, I define myself as a physician who cares for cancer patients but I am also responsible for training the next generation of oncologists (in other words, the people who might treat me). One of the most intriguing interactions for me is the conversation that I have with young doctors trying to decide what type of medical practice they will enter. 


Typically, when young doctors want to talk about their onion cores, I find myself offering the following advice. I start out with the obligatory disclaimer: there is no perfect job.  A job, I go on to underscore, is inherently a relationship. As most of us know, there are imperfections in every relationship, including the best marriage. With that expectation-management out of the way, I proceed to offer three criteria for addressing the dilemma of "what should I do now that I''ve grown up."

On a practical level, one''s occupation must provide gainful employment. Regarding “gain,” the decision of how much we want to earn depends largely on the lifestyle we choose to lead and what we want to do with that money. Do we want enough only to pay the bills?  Do we want more than the minimum so that we can afford extravagances and/or generous gifts of charity?  The answer, I believe, is an extremely personal matter to be thought through carefully, so that, throughout life, we will find our prioritization a comfortable fit.
Along with the question of gain, there are two intangible but essential questions to answer. What will give me joy? What will give me meaning? The readiness to reflect on those two factors usually, I think, differentiates satisfied professionals from those who burn out.  I believe that reflecting on joy and meaning is also a worthwhile exercise for those who are not currently immersed in a job – whether because of parenting choices, unemployment, retirement, etc.
In considering meaning and joy, it’s important to layer the onion wisely. As a cancer specialist, I find joy in the science of what I do. I love thinking about how to use modern tools, such as new drugs and radiation, to overcome the menacing tumors that are my foes. I enjoy also the intellectual challenge of figuring out how to deliver therapies safely so as not to cause patients to suffer side effects that compromise life quality. Closer, however to the core of my onion, I find deeper meaning in the challenge of figuring out how to restore to patients hope that, often, they’ve lost.
Many friends and relatives struggle to understand why I selected such an ostensibly depressing field as oncology.  I''ve interrogated myself with that question many times, so I know that I didn’t make the decision based on opportunities for monetary gain, or, even for love of science. Those are definitely layers but I chose my career because, closer to the surface of my value-indicating onion, I was initially, and still am, drawn to helping human beings who are at risk of losing hope.
In the feedback from colleagues in response to my editorial, I see that many were prompted to peel back and examine the layers of value-indicators of their own onion.  While I give mine another check, perhaps you’d like to explore the arrangement of joy and meaning layers within your life. 
Shalom, Ben.
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