In six months, my plan for the future will officially run out.

Now, if you happen to know me, you’ll know that I’ve never been one for planning for the future. I like to think of myself as being spontaneous, and being able to go with the flow. The alternate way to spin this, though, is that at very random times, I can be impetuous and impulsive, with no regard, or at least very little regard, for the consequences at hand. And I tend to favor the path of least resistance, which we all know eventually leads to the bottom of the sea.

But there are good, well validated, reasons for my devil-may-care attitude. If you think about it, we control very little about our lives. The outcome and course of your life is at least 50% determined by the personal characteristics and socioeconomic status of your parents. Things like what kind of high school you go to are completely controlled by (1) accidents of geography and (2) how much money your parents are willing to part with in order to stack the deck in your favor when you apply to college. Other things, like who you make friends with, and who (or if) you marry, are also largely accidents of propinquity. If you stop and think about it, the things you have the most control over are things you probably take for granted, and do over and over again, day and in day out, and sadly, rarely savor and enjoy.

Hence, the thing that my oldest friend taught me when we were still in high school: the simple pleasures in life are what count the most.

But this is where the path of least resistance thing clicks into place: at least 67%-75% of my extended family are in health care. So it was probably the most natural thing for me to follow in their footsteps.

There were many junctures in my life where this particular goal came into extreme doubt, but the decisions are too many, and there were too many twisting and turnings for me to even imagine what my life would be like now if I had chosen otherwise.

In the end, this one goal I set for myself, and at times took for granted, guided the course of the last ten years of my life.

Truth be known, I’m going to be three years behind schedule, but by my standards that a pretty decent margin of error. I’ve most definitely taken some interesting detours along the way. If everything had gone accordingly to plan, though, I would’ve been done with medical school and residency by the time I was 28.

On the other hand, sometimes Luck gives you small, but valuable and worthwhile, gifts. If I had started residency more than a year earlier than I did, I would’ve done my intern year without the protection of the mandatory 80 hour work week or the 30 hour (24+6) day. (As miserable as it was already, I can’t even imagine how awfully painful this would’ve been.) I I had finished medical school a year later than I did, I would’ve had to pay $1,000 for having the privilege of taking the clinical skills examination as part of the licensing process, which basically involves spending half a day interacting with fake patients. From what I understand, the only real thing it does is weed out the complete sociopaths, but of course no one is ever going to do a rigorous analysis of whether or not this test even succeeds at this modest task.

But I am certainly at an Iñigo Montoya moment. I’ve been so busy with becoming a physician, that I have no idea what I want to do with the rest of my life. I have this premonition that it’s not going to be an overly long span of time, in any case, since I don’t do very much to maintain my health, and I’m finding that it’s actually starting to fail in some ways, but whether we’re talking about the next few years, or the next few decades, I still find this great big yawning chasm of the unknown before me.

I suppose I also learned a lesson from the movie “City Slickers”, specifically from the late Jack Palance: one thing.

All it takes to have a good reason to live is to have one single goal.

And that would be a Christmas wish come true.