Who Are You, Really? Part 1: Identity.

On Sunday, March 4th, 2012, I found myself in the front passenger seat of my just-leased black Audi A6 with 3 of my 6 children on a drive north of Minneapolis to a destination not of my liking: Hazelden drug rehab center in Center City, Minnesota. I had finally raised the white flag of surrender in my battle with prescription narcotic addiction.

It was bitterly cold outside, but the sky was crystal clear, the sun bright — all the normal uplifting signals of a new spring right around the corner. The mental dissonance of the hope of spring with my mess…well, it sucked. The mental weight of my losses mounted with each new mile on the digital odometer — loss of springtime, my family’s stability, my relationships, my position at work, my health, and my integrity. The deafening silence with my kids for the 40-mile ride didn’t help much either. There was really nothing to say.

My son pulled the black sedan into the circular driveway in front of the entrance. It was like a scene from a cop movie — my three kids opened the car doors, stepped out in silence, and walked me, the future prisoner, through the institution’s front door. After a hug from each of them, drenched in silence except for an “I love you,” my son Sam handed me the small suitcase they had packed for me and left, free of the weight of my messed up presence.

As I followed the receptionist down the hallway to the intake area, I started to suffocate in the undertow of a wave of loneliness and isolation that washed over me. Two weeks ago, I was a full professor of surgery with an endowed chair, the program director of the general surgery training program…..etc. etc. — and now I was just another miserable drug addict in rehab, being given a tour of the facilities by an alcoholic medical student from Harvard!

I was not happy to be there, and in fact, I learned near the end of my three-month incarceration that I had been voted least likely to succeed by my fellow inmates! But not to worry, since I had also been voted most improved by the same bunch.

Hazelden was a 12-step-based program, so it inculcates people (brainwashes, reprograms, teaches….) people struggling with addiction to adopt the identity of “drug addict.” The reprogramming started in the first group meeting — seated in a circle facing each other, we took turns saying our name followed by either addict or alcoholic. Since I was definitely not an alcoholic, I chose addict.

“Michael, drug addict.” Two weeks ago, a big shot academic surgeon. Now, a drug addict.

Three months later, in early June, I walked back through the door of our home. It felt like I had just returned from an overseas military deployment. My wife Lea and our 2 girls had also been on their own deployment, on their own.

I felt healthy again — physically anyway. Mentally, I was more like a rickety rickshaw boat being tossed around in the storm-like weather of my emotions and the total loss of my sense of who I was. Now, I am a drug addict. Before, I was a surgeon. I had no idea of who I was, really. My identity was shattered. Talk about a mindf#%&.

I managed to surface from a destructive and difficult childhood and hopped on the train of “success” — college, med school, residency, fellowship, and 20 years of a great academic career. The ground seemed so firm and real and permanent. Now I was in quicksand and lost. My identity was built on a house of cards, and now the cards were spread out all over the surface of my life.

I only knew two things for sure at this point: I was determined to help my family heal and I was done with my career as a surgeon. Every time I thought about the idea of returning to work, my gut, my brain, every fiber of whatever those fibers were tightened around my mental neck.

Why didn’t I want to go back? It was hard for me to know without bullshitting myself. Was I so traumatized and afraid and weak, or was I really, really done? Though I had been through many, many difficult things, my little addiction event was in the running for the Academy Award for Best Mess Created. Fear played a role, but it was not the real issue. One of my superpowers is facing fear. I concluded that I was really done with my whole academic career gig. Actually, fear was the issue! Fear of relapsing into the grind of so much of the work that had come to hold little meaning for me.

In my pre-Hazelden existence, pre-pills, my emotional life seemed simple and superficial — I skated around on the smooth surface of my brain’s emotional repertoire: I was either in a pretty good or bad mood. I had never learned to dig deeper for what was going on emotionally under the neurological hood of my conscious awareness. In Hazeleden I was forced to practice being an emotional archeologist to dig up what the hell was going on in the rubble of my subconscious mind.

A couple of weeks later, with the mental dust of my reentry clearing, Lea and I were pondering (pondering — a miserably inadequate word for the moment) the reality of me leaving my career. As we were “pondering,” I got to digging and discovered another big fear hidden deep in my subconscious cauldron: that Lea and my kids would not love me anymore.

There, I said it.

They only knew me as this high-flying, hyper-”successful” academic thoracic surgeon. Would they love me as just a man sitting around the house? As a washed-up drug addict?

The hot lava of fear bubbled up into my throat, nearly choking me, but now, under the new protocol of expressing my feelings, I said it to Lea: “I am afraid that if I am not a surgeon, you and the kids won’t love me anymore.”

She looked up and gave me a WTF look, and said something like, “That’s ridiculous.” Given the global set of circumstances at play, I felt pretty happy to get that, though a hug would have been nice.

Until now, I was unaware of the strangulating grip my identity as an academic thoracic surgeon had on me. I called the chair, and told him I was “retiring”. He said he understood, that they would miss me, and wished me luck. Two minutes of conversation and 30 years of my old life was done. I hung up and choked back the urge to vomit.

I was no longer a surgeon. I no longer knew who I was. Like an alcoholic who has tension about what to say in social situations with alcohol, I was now flummoxed and so anxious about what to say to people in public if and when they asked me about what I do for a living, or any other aspect of who I was.

I pondered (a lot of pondering in those days!) a lot about how to fill the gaping hole inside me with things like volunteering in the surgical simulation lab for medical students. I even met with the associate dean to explore this and other ideas. They were enthusiastic, but I was not, at all. I realized I was pushing this agenda simply to avoid the difficult feelings of loss and identity disruption.

Given that I was on the new “can’t avoid your feelings track” of life, I said the hell with these efforts to escape my bad feelings. I decided to commit to the one thing I knew I really cared about: my family.

I became a house husband. My wife, Lea, was still working as a high-risk obstetrician, and two of our daughters were still living at home. I executed my new role as a house husband with a surgeon’s precision and intensity. House — clean and sparkling. All administrative issues — tidy. Drove our young Anne (10 at the time) to school in the morning and picked her up in the afternoon, with warm banana bread in the oven timed to come out perfectly upon our arrival home.

In fact, I was such a good house husband that one day, Lea walked in the door from work to a sparkling clean house, flowers on the table, dinner in process, and the girl’s issues all taken care of. She plopped down in a chair, dropped her bag on the floor, started crying, and said, “I guess I am just not needed around here anymore.”

Over time, Lea adjusted beautifully to the new setup, and I had a sense of purpose again. Being a house husband was an extraordinary experience, both difficult as hell and also one of enormous personal growth.

I learned to be alone during the day. I learned how to be bored and not have to fill every moment with shit to do. I learned how to be a father who actually knew his daughters, what their rhythms and personalities were like, and how to guide and nurture them more than just showing up at a school function. I learned how to be a better husband and mate. And I learned how to think, something there was never time for in the high-speed freeway of living that I had previously been addicted to.

But the question of who I was lingered in the back of my mind, like an itch that needs to be scratched. I was never going to accept the identity of “addict,” though I get the reasoning — never to forget. Was I now a house husband? Yes, but that role, like being a surgeon, was something I did, and it was certainly part of who I was in some sense, but I knew there was more.

One thing they encouraged me to do at Hazelden was to consider what my values were. I had never sat and thought deeply about what my core values were. I had never had such a thing even suggested to me, and even if someone had, I suspect I would have blown it off as some sort of woo-woo. But I did the exercise and realized how deep some of my values run — kindness, patience, loyalty, persistence, and commitment — and how much they influenced me.

This was a good start, and now I believe getting clear on one’s values is an essential step in self-awareness and knowing who you are deep inside. Here is a good exercise to help you discover what your deeper values are.

In her sensational book Quit, Annie Duke notes that quitting our identity creates the kind of heavy cognitive dissonance that I experienced. Our identities are, in fact, built on a house of cards — beliefs, actions, past decisions, etc. It’s all a mental construct lodged inside the modular neurologic systems of the 3-pound brainloaf of 100 billion neurons inside the dark, silent vault of our skulls. The house of cards gets built over time as more and more gets fed into the brainloaf — and it starts to really, really feel like that is who you really are.

But it’s not real. It’s an illusion. It is made up. Sort of.

Next up: Who Are You, Really, Part II: Big 5 Personality Test.

Thanks to Dr. Brian Little, author of Who Are You, Really for permission to use the title of his brilliant book!