The Worthy Physician

Second Acts: Redesigning Your Medical Career Path

• Dr. Sapna Shah-Haque MD

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Dr. David Weill shares his journey from transplant pulmonologist to consultant and author, exploring how he recognized the emotional and physical toll of clinical medicine after 20 years and strategically transitioned to his "second act." He provides honest insights into the realities of medical practice, the importance of knowing when to pivot, and the value of pursuing creative outlets that align with your strengths.

• After 20 years as a transplant pulmonologist, Dr. Weill transitioned to consulting and writing
• He recognized early that clinical medicine had a "shelf life" due to physical demands and emotional toll
• Used a methodical approach of listing what he excelled at and enjoyed to guide his next chapter
• Now works as a consultant helping transplant programs improve their systems and outcomes
• Has published two books: "Exhale" (a memoir) and "All That Really Matters" (a novel)
• Emphasizes the challenge of accepting medicine's imperfect outcomes
• Recommends "test-driving" potential new career paths while still in your current role
• Highlights the importance of the "three Fs": family, friends, and faith (spiritual practice)

Visit davidweill.com to learn more about Dr. Weill's books and work. He welcomes emails from medical students, residents, and physicians considering career transitions.


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Dr. Shah-Haque:

Welcome to another episode of the Worthy Physician. I'm your host, dr Sapna Shah-Hawk, reigniting your humanity and passion for medicine. With each episode, we bring you inspiring stories, actionable insight, and expert advice. Get ready for another engaging conversation that change change you think and live as a physician. Your income is your greatest asset, protected with Pattern Life. The easy, stress-free way to find the right disability insurance, with unbiased comparisons and no jargon. Pattern helps you to choose the best policy for your needs. Secure your future today at Pattern Life. The link is in the show notes. Let's dive in. As we go through medical school, we have an idea of the will our career take. What happens when we end up in a spot that we never imagined Today, dr Weil, thank you very much for being here. I I'm a transplant pulmonologist.

Dr. Weill:

And I directed the team at Stanford. Part of the team was surgeons. They have a critical role, obviously, but I'm a pulmonologist. I was in charge of taking care of the patients, putting them on the waiting list, keeping them going until we could get the transplant done, and then surgeons would do the operation.

Dr. Shah-Haque:

So that's what you trained to be and you went through medical school, residency and fellowship and that's quite a few years of training, and I think that we're taught this path that once you start medical school, you're expected to go into a clinical residency, continue with clinical practice and if you do anything other than that, then in some realm which is not true, but in some realms you're thought to be not a true physician, and I don't believe that at all, is not true. But in some realms you're thought to be not a true physician, and I don't believe that at all. Once a physician, always. How did you transition from being a transplant pulmonologist to your role in consulting and writing now, which I find fascinating?

Dr. Weill:

Yeah, I always got the idea that I was going to have this kind of a second act, if you will, or a second chapter, even very early in my career.

Dr. Weill:

I thought I had about 20 years in the hospital doing this kind of work. I got a taste of it early in my career and I realized it probably had a shelf life to it, and so actually it almost worked out to the day 20 years on the front lines of medicine, and I got a legal plan out and just sketched out the things that I do well and that I like to do. I'm going to keep doing those. I'm going to try to do more of them, and the things that I don't do well and I don't like doing, I'm going to stop doing those. And I've tried to focus this next chapter of my life in doing the things that I really like and the things that I think I'm pretty good at, and that's been really my guiding principle throughout. I love tinkering and trying to fix broken clinical programs like transplant programs. That's what I do now, and I also like expressing my thoughts in the written word mostly, and I've been able to do both, which I think is lucky. I think it's just it's good fortune.

Dr. Shah-Haque:

I will circle back to that in a minute because I want to highlight your writing, which I think is awesome. What is the like throughout your training? What were the warning signs or what was the situation that made you think this chapter of clinical medicine or working as a transplant plant pulmonologist like hands-on with patient care? What about that made you think this has a shelf life and it's going to be about 20 years? Because I think that's a great way of thinking, but it's not common and if physicians start to look at things like that again, there's a lot of pushback.

Dr. Weill:

I think you're exactly right about the pushback, and I walked out of Stanford when I was 52 years old and that would be considered young, I think to leave a position that I worked all my life to get. But I think it became clear to me really early on that there was two issues with regard to the work that I was doing. One was the physical. It's just a lot of night work, it's a lot of long hours, transplant patients get sick when they get sick. Organ donors become available when they become available. So there was that part of it, and then there was the emotional part of it, which I think was equally, if not more, difficult than the physical part of it.

Dr. Weill:

I lost patients. I write about this in my book. I lost patients to whom I was very close and also to the family members. This was not a practice of medicine where you had thousands and thousands of patients. You had a smaller group, maybe hundreds, but you really got to know them quite well, and so the responsibility that I felt like I had to get them through the operation and back home was one I took really seriously, and it ultimately what got me out of the clinical realm really was my dissatisfaction at the imperfections of what we did. I was going for perfect, and perfect wasn't available in a transplant, and maybe it's not available in any part of medicine, but at least in my part of medicine it wasn't.

Dr. Shah-Haque:

That's very profound. I don't think that there's perfect outcomes in medicine at all when you're dealing with humans, because there's so many variables that we can't account for, and I think that's one thing we forget as physicians in clinical practice. They call it practice for a reason, but what gave you that insight? Because a lot of physicians, I think, would just power through and just say this is part of the job, without really honoring the connections that you've mentioned, which I think is very beautiful.

Dr. Weill:

Yeah, I think there was. I do see a lot of powering through among my colleagues. I saw it in myself for much of my career, but I also was well aware, even in real time, of the special relationships I was developing with my patients. I think it was not very common. I think that I was looking for that. I needed that. I know that the patients and their families needed it, but I also needed that relationship and it's in fact the thing that most happened not doing it right now.

Dr. Weill:

But I also was acutely aware that not everybody went off to work every day, and I'm talking about people out of medicine that have this kind of responsibility. And I was perfectly happy earlier in my career to relish in the successes of what we did. But then there's a flip side to that. You also have to really experience the failures quote unquote, if that's the right word of when a transplant doesn't go well, and I looked at it. Much of my career is failure.

Dr. Shah-Haque:

That's a very humanistic thing to say. We don't hear that very often in medicine and I appreciate your candidness. And so when you were looking at transitioning into consulting and writing, you said you pulled out a legal pad and you wrote down what you like doing and what you were good at and what you weren't so keen on, and maybe what you wanted to get rid of. What spurred that step? Was it the? I'm ready for a transition and I need to figure out what the next step is, Because a lot of times that first step is the hardest to overcome.

Dr. Weill:

Yeah, I think it really is. I saw this coming for a year or so before. I sent an email out to our entire team and told them I was going to be calling in six weeks. But I saw it coming and I didn't think in my heart that I didn't have anything left to give. I just thought that I was going to have to do it in a different way, that I was not going to be able to work in one transplant program and see one patient at a time. I thought that I wanted to do something on a bigger scale and I did think that I had some expertise in making programs perform better.

Dr. Weill:

I think of anything in my career that's probably the one that I'm most proud of just to put in place the infrastructure, the personnel, the protocols, the whole operation, and I wanted to continue to do that. So I essentially started to export what we had done at Stanford to other hospitals, and I think that was well-received. I think that's what some hospitals want and it's all good, and I've told a lot of physicians this that are thinking about doing the same thing. We can look at it anything that you do as replacing that one-on-one patient-physician interaction. I have not found that replaceable. But what you can do is you can actually make an impact, and you can make an impact in a different way, but I wouldn't have the expectation that you're ever going to be able to replace sitting in a waiting room in the ICU with the patient's family and talking them through the options or talking to a patient about transplant. That, to me, is irreplaceable.

Dr. Shah-Haque:

That's beautifully said. So it sounds like you've really enjoyed that scene of your life and you appreciate that. But now you've transitioned to make bigger impacts and impact those relationships through improving those programs that you're interacting with.

Dr. Weill:

Yeah, I think it's gratifying. I think it's the same. I'm using the same expertise and in fact I'm using the things that I've learned all the way along and just going at the problem in a different way. So not one chance, one program at a time, but on a broader scale, and it's really fit in well to where I am now. It's fit in well professionally, it's fit in personally, it's truly where I am. Just to wear out that cliche, it's where I am right now.

Dr. Shah-Haque:

And so it's honoring that second act, honoring that shelf life that whatever you started doing does not have to be the end, all be all, and honoring where you're at in life and would you say that this transition to doing what you're doing now has also allowed for your writing, oh for sure.

Dr. Weill:

Not only has it allowed the physical time to write, which does take a lot of time it doesn't come in 15 minute increments, you have to block off time to do it but I also think it allows quiet, and I think quiet is key to writing. I think that I have a very noisy brain. Probably a lot of your listeners have noisy brains Part of being a doctor and I have to quiet it way down for me to be able to put something on the page. And I don't see and I know people do this out there I don't see how anybody can have a busy clinical practice or a busy law practice or be a stock trader or whatever else is stressful and then try to quiet their brain down to write. I can't do that. So I've actually needed both the time and the space to be able to get something on the page that people want to read.

Dr. Shah-Haque:

Now you say that you have written two books. What are the titles and what inspired you to write them? What inspired you to start writing?

Dr. Weill:

Yeah, my first book was a memoir called Exhale, and the title says it all. It was at the time I was leaving Stanford. I had a lot on my mind. I just experienced this 20-year rip in the hospital and there were not only incredible patient stories but also reflections of what I was going through emotionally as I did this kind of work and also what the team was going through. It's not just me, it's 60 people on our transplant team when I was at Stanford, and so I wanted to get all that down, because I don't know about you or any of your listeners, but when I walk around the hospital sometimes I'm by myself and I feel like looking over my shoulder and saying are you seeing what I'm seeing? It was incredible and I wanted to bring the reader into that environment.

Dr. Weill:

I felt like with the memoir nonfiction there were real people involved, names changed, obviously, real institution involved. I felt like I couldn't go quite as far as I wanted to because of the sensitivities of it Patient confidentiality a lot of institutions don't love it when you write about them. So I decided that I was going to write a novel about a lot of the things that I had seen, but I could go further because it was fiction. And so I have a heart transplant surgeon protagonist. He's very much like a lot of people I worked with and saw. I have a team of people very much like the people I worked with and thought and put them in situations and put this guy who's on top of the world, get him into a little bit of trouble and see how he can dig himself out of it. I felt like I could explore things a little bit further Now with the third book which I'm working on. Now I'm leaving Madison Alt again. These two books are out and these are the ones that I think best describe what I've been talking about.

Dr. Shah-Haque:

Thank you for that. And how did you make the transition? Besides having the content, how did you, in creating space, how did you allow the physician self to become the author self?

Dr. Weill:

Yeah, the first thing I had to do is figure out how do you write a memoir, how does it work? And then I had to figure out how to write a novel and I took a couple of classes while I was at Stanford and I listened and read and talked to people in the industry and I worked with an incredible editor, claire Wachtell, and all these steps have really helped me a lot. The first is I had to be honest, like I had to sit down and say look, I'm not going to make myself look better than I am. I'm not going to make healthcare look better than it is. I'm not going to idealize any of it. I'm going to tell it like it is, and some people are going to love that and some people are going to hate that, but I'm going to tell it how it is.

Dr. Weill:

And I made that decision before I wrote my first book. And then it's like any writing that you've done or any of your listeners it's hard. It's hard. And I also had to knock the academic writing out of me. Like a lot of people in academics I'd written a lot of papers Couldn't write like that anymore. Nobody would want to read it if I did write like that. So I had to really do a lot more storytelling, but I think the first one was let's not write, let's not be a typical doctor writing a typical book about the magic of it all, even though I think there's a lot of magic in it. Let's tell the truth, let's be pretty honest about what's going on out there.

Dr. Shah-Haque:

And so the first book is Exhale, and then the second one is All that Really Matters, right, and the links will be in the show notes for the listener. And so you have a nonfiction, which is a memoir, and then a novel, which is fiction, so you can go further. And so you said you're working on a third one. What keeps you writing, what keeps you motivated and engaged in that creative space? Because sometimes that's a lot Engage.

Dr. Weill:

Yeah, no, it's difficult. I actually I so much like it that it's not hard for me to sit down and do it. This third book I have a deadline of James McFurt, so I'm definitely on task right now to get the draft to the publishing house. But I think more than that. I think something that you're going to spend two or three years on, and that's how long it takes me to get these books done. You really have to be obsessed with whatever topic you're trying to explore. You can't be mildly interested in it, and I talked to a lot of writers I've gotten to know through this process. Michael Lewis, a nonfiction author who I went to high school with, so I got a chance to talk to him said that you really you become obsessed with what you're writing about, and you really have to be. I don't know any other way to do it, and I think the key is to choose the topic you're going to write about really carefully, because you're going to live with it for two or three years.

Dr. Shah-Haque:

So that's a lot of time, creativity and brain power, but for the listeners, I think physicians have the gifts that you're discussing the potential, because we definitely know how to if you're passionate about it and again, I agree that you have to be obsessed. It's the reason why I've been doing this podcast, but it's quieting the mind, creating the time and space and keep on working toward a goal when you're writing which I think may not come naturally to all the doctors, and I don't think it came naturally to me either.

Dr. Weill:

It is trying to explore deep down what I really think about. Whatever it is I'm writing about, don't skim on the surface of it. Really get down to the root of it, and I think that makes for interesting reading.

Dr. Shah-Haque:

Yeah, thank you for pointing that out, because it's no easy task by any means.

Dr. Weill:

Yeah, you're right about that, and I also think that there's not everybody has a tendency to tell their life story or to tell their experiences Honestly. A lot of people are just more private. That's fine, but I think if you're going to put something out there for people to read, you're exposing yourself. There's no other way around it and you have to be comfortable with that.

Dr. Shah-Haque:

Yeah, that's a very good point. So, in this season of your life, you're a consultant, you're an author, you're working on your third book, you are engaging in a different skill set than 20 years previous, but what you have learned previously is coming forward within what you're doing now.

Dr. Weill:

Yeah, definitely. I don't think I could or would write a very interesting book when I was 30 years old. I'm not sure the people do, but I'm not one of them. I think I had to go through this whole experience before I could really sit down and write some of the things that are on my mind.

Dr. Shah-Haque:

And, overall, how is the second act going? You look like you're happy.

Dr. Weill:

Yeah, no, it's really exceeded expectations. But I have pretty high expectations and really it's exceed. I get to do the things that I like to do. I'm in touch with my field. I haven't lost my love of transplant. I haven't lost my interest in impacting. I still get to do that. And I get to develop this new endeavor for me, which is writing. I feel like, in a lot of ways, I'm in my early post-residency period with writing. I'm on the learning curve. I want this third book to be better than my second, which I thought was better than my first and I want to continue. Like medicine, you just put the blocks in place and you keep growing. I want to do that with my writing as well.

Dr. Shah-Haque:

So it's a learning curve.

Dr. Weill:

Yeah, it is it? Is yeah, I can feel myself getting better at it. I'm by no means a finished product I don't want to imply that but I feel like I'm getting better at it. I'm able to say what I want to say clearly, and even do it faster than I have in the past.

Dr. Shah-Haque:

So, for those that are listening, if they have any doubt about engaging in something that is off the beaten path or in a creative endeavor, what advice would you give to them?

Dr. Weill:

I did this and I think that this word for me is and I don't know if it works for everybody I would test drive it. I got the opportunity toward the end of my time at Stanford to test drive the consulting part. Got the opportunity toward the end of my time at Stanford to test drive the consulting part of what I do. I was already starting to work with programs outside, not just Stanford's program, but being asked to help other in a consulting role. I think that was important for me to figure out. Yeah, I really like this. So if you have an idea in mind, you might want to test drive it while you're still in your primary job or the first chapter of your life, or your first mountain, david Brooks terms.

Dr. Weill:

I also started writing my memoir before I even left Stanford. It was like the last year I was there. I started scribbling down what I was going to write. There was no formality to it, but it answered a threshold question Do I like to sit down and write? And the answer is yes. I found safety and comfort in trying some things out before you do them full time, before you make the big leap into another field altogether. It's very much to wear out. This cliche is trying to close on its store. You look in the mirror and you figure out if it's a nice fit, all that kind of stuff. I felt the same way with this. I'm the kind of person that I want to stack the odds in my favor, and for me, giving it a test run was the best thing.

Dr. Shah-Haque:

I appreciate that and I appreciate the analogy as well. It's something that we've all done and if the listeners wanted to reach out, you can, or even and I would encourage to read your books.

Dr. Weill:

Where can they reach you? Probably the easiest thing is to go to my website, which is not imaginatively named. It's davidweilcom, so davidweilcom. Pretty much everything that I'm up to is on the website. I'm pretty easy to find out there. I answer any emails that come my way. I have a lot of students, medical students, pre-med students, residents, people, mid-career that reach out to me. I don't hold myself as an expert on any of the matters that we've talked about, but I can tell folks what I experienced.

Dr. Weill:

And they may find some resonance in that. So I'm happy to talk to anybody about whatever career ups and downs we're experiencing.

Dr. Shah-Haque:

I appreciate that and I think that's beautiful, just. We need more like that. We need those individuals that we can reach out to add something that's always two steps ahead of us. Those are great people to learn.

Dr. Weill:

So I really appreciate that. Yeah, I think it's especially important for those that have been on the front lines of medicine because we're not talking about it as a business school management problem. We're actually lived it and I think it's helpful. And I also enjoyed much talking to people that are pre-meds. I talked to a lot of pre-med societies. I talked to medical schools, people that are just forming their career, some things to keep in mind that I, from a generational standpoint, no one was talking about when I was going through it all, but I think we have to now, given the current state of healthcare, I think we have to.

Dr. Shah-Haque:

Absolutely. I'm pretty upfront about that with my pre-meds and my medical students as well, because there's a difference between what we expect, then the training we get, and then the way real-world medicine is practiced. It's a complete 180, then, compared to what we're taught.

Dr. Weill:

Yeah, yeah.

Dr. Shah-Haque:

And for the listeners, what is one last pearl of wisdom you would like to leave us with?

Dr. Weill:

Yeah, I think the most important thing I talk about this a lot is the three Fs, as you're practicing medicine especially, but I also talk to groups that have other high-pressure jobs lawyers, stockbrokers, care-run pilots. When I found myself struggling, mostly I got disconnected from what I call the three Fs, which is family, friends and faith, and when I did the best I was connected to all three of those Family and friends. It's easy to figure out what that is. Don't isolate yourself. Stay connected, make the extra effort. Faith is a little different one, because I think most people would think that's formal religion. I'm not proselytizing in any way. Faith to me is spiritual and anyway, faith to me is spiritual. It's whatever practice you have that calms your mind, whether it's writing or meditation or yoga or sitting on the beach, whatever it is, but don't lose that part of your day where you're actually going to connect to that spirituality and your family and friends and what gets you through it all. So the three F's is where I'd leave it.

Dr. Shah-Haque:

That's beautiful you said, and thank you for putting that up front. The three Fs is where I'd leave it. That's beautiful we said, and thank you for putting that up front. The three Fs. Thank you very much for your time and for all your great words of wisdom. I think these are very important for other physicians to hear because a lot of times we don't most of the time we don't talk about everything you've highlighted. I can't see myself doing this exact same thing for 50, 60 years. I knew this had a shelf life. I'm okay with transitioning and I want to explore a creative side. I think that's beautiful. Thank you for everything that you're doing and I just appreciate the insight.

Dr. Weill:

Thanks for the conversation.

Dr. Shah-Haque:

Absolutely. Thanks for tuning in to another episode from the Worthy Physician Podcast. If you enjoyed this episode, be sure to subscribe, leave a review and share it with someone who'd love it too. Don't forget to follow us on YouTube, linkedin, instagram for more updates and insights. Until next time, keep inspiring, learning, growing and living your best life.