On this episode, I had a conversation with Aidan Crowley, someone that I am very honored and lucky to call a friend. She is currently an MD-PhD student at the University of Pennsylvania, and the way she thinks never fails to inspire me. We talk about the concept of “de-differentiation”, or the process of stepping back and considering multiple paths rather than being narrowly focused. We touch on embracing change and being open to new opportunities, and how originality comes from combining different ideas in unique ways. I hope you guys enjoy. My reflection is below. (Aidan and I had this conversation back in November, but it’s just as impactful now as it was then.)
Until my final semester at university, I had always planned to go to medical school. I was dead-set on it, until I studied abroad in Copenhagen my spring semester of junior year. It was an experience that fully immersed me in international medical systems. I shadowed doctors in OBGYN, general surgery, and mental health, took intensive classes, applied medical knowledge, and even visited different hospitals not just in Denmark, but in Germany and Poland. It was a budding doctor’s dream. However, Danish people are generally really blunt. One day, my Medical Ethics professor took me to the side after class and said, “Jethro, I don’t think you should be a doctor.” Imagine my reaction – an idea I planned my entire life around, utterly destroyed in a matter of seconds. She must have sensed something was off, or maybe just saw the sheer shock on my face, because she quickly corrected herself, saying, “Don’t get me wrong. I think you would be an incredible doctor. But, to me, it doesn’t feel as if your heart would be fully satisfied if you went down this path.”
It didn’t matter if she was right or wrong. In fact, even now, four years later, I still question what would have been if I was in medical school right now. What mattered is that, for the first time, I was encouraged to take a step back and properly evaluate the direction of my life. That summer, I ended up dropping the pre-med track. While coming to that conclusion was a rather stressful and overwhelming process, the moment I made the decision, I only felt peace. I didn’t know what was going to come next (in fact, I’m still figuring that out), but I knew that going to medical school was not the right choice at that time. My Medical Ethics professor will always be one of my favorite people not only because she taught an incredible class, but because she challenged me to seek the life that I would ultimately fall in love with.
Aidan and I bonded for two reasons: she studied in Copenhagen a semester after I did — in fact, she had the same professor I had — and she continued down the intense medical path that I left. It’s not an exaggeration to state that the academic/medical part of me lives vicariously through her. She prides herself on being curious and always wanting to learn; so much so, that she’s doing a total of 8 years post-undergrad to get an MD and a PhD at the University of Pennsylvania. Whenever I talk to Aidan, I always get a small feeling of regret for not continuing down the medical path. Not a big enough regret to think my decision was the wrong one, but I definitely take every opportunity I can to talk to her and learn more about how she’s enjoying medical school.
She shared with me an article she wrote about the idea of dedifferentiation and re-differentiation in cells. You can read it here, but basically, as cells grow older and develop, they prioritize certain functions, losing the ability to perform certain things but becoming better in others. This is known as differentiation, meaning they differentiate from a general state to a more specific state. Sometimes, cells face an external stimulus, something like an injury, that triggers them to dedifferentiate, or go backwards and return back to the general state. They are then able to re-differentiate in a completely different direction, fulfilling an another purpose altogether. In our conversation, Aidan talked about applying this cellular process of dedifferentiation and re-differentiation into her own life, saying,
“I might be getting too locked in on one certain path and it might be helpful to actually take a moment, pause, step back and say, okay, this is what I thought I wanted to do, but let me just let myself dedifferentiate for a little bit and really critically evaluate that before I re-differentiate once again.”
It’s the same thing that our Medical Ethics professor encouraged me to do, although she didn’t use the cellular analogy. And for me, listening to her ended up being very beneficial. Instead of getting stuck on a path I might not have been content in, I took a step back (dedifferentiate) and then went on a different path (re-differentiate). This is a process cells undergo quite often; in fact, it happens on a daily basis. And while we surely don’t have to go through that process as frequently, it serves as a good reminder to, from time to time, pause and reflect on our life, and, if necessary, adjust to live the life that serves us best.
Of course, it is easier said than done. I remember the summer I chose to leave the medical path to be very frantic. It was a very scary idea to fully let go of something I had held on to for as long as I did. It was, quite naturally, an identity shift, as well as a leap of faith into something unknown and frightening. It required me to challenge everything I thought was true and seek to understand myself better, in order for me to know what the right decision was. I had to ask and answer the difficult questions: “What are your real reasons for going to medical school?” “Are you happy?” “What do you REALLY want to do?” I had to face myself honestly.
Truthfully, I still don’t know what I want to do. Or rather, it’s that I’m afraid to take a step in any direction because it means closing myself off to another path or having to leave behind something that I also love. It is impossible to do everything we want in life all the time, and it’s a reality I struggle to come to terms with. As such, I am paralyzed and stuck in dedifferentiation, rather than taking the steps to move forward. While there is nothing necessarily wrong with being in a dedifferentiated state of pure discovery and exploration, I am not even doing that, not discovering nor exploring. Going back to my conversation with Aidan could not have been more timely:
“It's knowing that we cannot be the best at every single thing and that there are probably many different paths that we could be equally good at…I try to…focus more on the things I'm moving toward rather than on the things I'm leaving behind.”
We can either look back at the things we don’t have or that could have been, or we can look presently at the things we do have and forward to the things that could be. In this way, it is as simple as a perspective shift. Yes, there will always be doors that close and things we lose. But, eventually, we have to make choices, and with intentional thought, we make those choices for a reason. It feels much better to me to focus on the choice I did make rather than on the choice I didn’t.
I do want to clarify something. While I do believe that as we grow older we specialize and differentiate more, I don’t think we ever reach an end state. I think there is always room for change. I said this in the conversation, but while some doors may close, there are still an infinite amount of doors. And sometimes, those doors lead to the same room. For the most part, the choices we make aren’t permanent. While we can never undo choices we make, we can always pause, take a step back, and decide to move forward in a different way. While it won’t necessarily be as drastic as early on in our lives, we can always dedifferentiate and re-differentiate.
Which leads me to this: Why are we stepping back, reflecting, dedifferentiating and re-differentiating? What are we doing all of this for?
Well, we’re doing it for ourselves! I truly believe we are each meant to uniquely live a life only we can live. It is only by facing oneself, reflecting on those difficult questions, and fully venturing into the unknown that we can find that life. Or rather, it’s not a life to be found, but a life to be lived. Our true self is hardly a destination, but a constant journey. Aidan said,
“You are you, and whatever you do, you will apply yourself toward it. And then you'll just continue following this really scary, really windy path.”
It’s scary, yes. But it’s also exciting. I think we owe it to ourselves to chase after the life we were meant to live. I want to take the leap of faith, or many, to find the best version of me. And if that means making choices, re-evaluating those choices, and then making new ones, then I want to embrace that. If that means leaning into change, then I will do that. I want to experience my life of my own accord. I want to be the truest version of me, one that is always shifting and evolving and changing. I want to honor my authentic self, even if it’s scary. Because ultimately, I want to fall in love with my life.
I'll close with something Aidan said towards the end of our conversation:
“Go for it. That's my philosophy. If it it works, great. If it doesn't work, great. Because every interaction that you have, every choice that you make, even if it feels counterintuitive or like you're stepping back or like it might not be the right way, even if you hated it, at least you learned something about that experience and about yourself. And then you can take that and move forward into the next steps that you take.”
Aidan, as always, I am grateful for our conversation. Thank you for going upward together with me.