Whose Life are You Living?
- Jan 29
- 4 min read
Clarity When It’s Too Late
What if you knew the greatest regret you’d suffer on your deathbed? Would you live your life differently? In 2019, a hospice nurse named Bronnie Ware published Top Five Regrets of the Dying, a qualitative analysis cataloging the biggest sources of remorse among her end-of-life patients.
The number one regret was "I wish I’d had the courage to live a life true to myself, not the life others expected of me." Working in palliative care, I frequently meet patients facing an acute awareness of their short time left, and I hear similar sentiments.
Why is this such a universal source of remorse? Many factors contribute, including several of the other top five regrets—working too hard and being fearful about expressing feelings, most notably.
However, the most prominent cause of not living the life we want is even more fundamental: Most of us aren’t really sure what we want. We “need” to want something. So, out of convenience and necessity, we substitute the (apparent) desires of others for our own. This often happens insidiously and without our awareness. The result? When we have a moment of clarity, often in the face of a grim prognosis, the disguise obscuring our dreams is cruelly removed, revealing the path we’d really wanted, but never pursued.
Looking Under the Hood: Mimetic Desire
Mimetic desire was an evolutionary necessity; many of our ancestors survived by taking cues from peers about what their goals should be—which berry was safe, or which hunting ground was most productive. It’s a cognitive shortcut, a deeply ingrained human tendency to imitate the desires of others, and it served us well 20,000 years ago, when immediate survival was the primary concern. Today, in our world of overwhelming options and complex career paths? Not so much. It’s frankly best described as a "glitch" in the modern human operating system.
There are myriad examples of this among medical professionals, but even if you’re not in healthcare, you’ve seen (and probably experienced) the consequences of mimetic desire. The big house, the fancy car t, the picture-perfect nuclear family with 2.3 kids. Many people devote enormous time, energy, and money working towards these socially-sanctioned goals, sacrificing their true passions along the way, only to reach their destination and be left with a profound, aching sense of emptiness and dissatisfaction. Social media certainly doesn’t help .
Like so many aspects of our evolutionary programming, what once served as a survival advantage can now become among the largest impediments to us leading the lives we truly desire. Mimetic desire is no different.
We also change over time. The person who set that goal five, ten, or twenty years ago may be fundamentally different from the person reading this now. Are we mimicking the desires of a bygone, immature version of ourselves, clinging to a goal that no longer fits? Only you have the courage to honestly ask, and answer, that question.
Risk Mitigation
If you’re health conscious and have a family history of heart disease, you probably make extra efforts to eat well and keep fit. This is prudent. If your heart health is known to be your greatest liability, there’s wisdom in doing what is within your control to mitigate the risks of cardiovascular disease.
Based on Ware’s findings, we can safely assume that for most of us, we are most at risk of regretting chasing someone else’s dreams. Like the genetics of heart disease, this reality is not deterministic; we have agency in affecting the likelihood of the dreadful negative outcome.
Warning Signs and Taking Control
Just as the warning signs of heart disease usually precede fulminant heart failure, the harbingers of regrets related to a life of mimetic desire are almost always evident years before the damage is irrevocable. What is commonly referred to in medicine as “burnout,” which has corollaries of dissatisfaction and boredom in most professions, is the hallmark feature of mimetic desire. I’m not talking about a bad week or month. This experience is pervasive, dreadful, and ignored at the peril of our future happiness.
Burnout is sadly incredibly common among emergency physicians, yet no profession or lifestyle choice is occupied by universally satisfied individuals. I often wonder how many fewer ED docs would be burned out if, as a group, we were as familiar with anti-mimetics—the conscious effort to identify and reject borrowed desires—as we are with antiemetics? Perhaps the core curriculum on identifying and following authentic desire is what the specialty truly needs.
What Being Yourself Feels Like
As for me, I now unapologetically enjoy the unrushed conversations with patients about their often minor symptoms and chatting with my staff about their upcoming vacation plans that are afforded to me by working in urgent care and rural EDs. The very same settings that many high-acuity ED docs (my former self included) scoff at, dismissing them as "not real medicine." I’ve traded the relative prestige and external validation that came with the “street cred” of working in high-acuity EDs for the profound satisfaction of work that aligns with my values, sensibilities. I get to learn, grow, teach, and affect change in ways that are personally meaningful.
Finding Your Path
So, as the saying goes, before you climb the ladder, make sure it’s against the right building. The longer you’ve been climbing, the more at risk you’ll be for influence from the sunk cost fallacy. But when you know you’re on a path of unhappiness, the best time to change course is yesterday, and the second best time is today.
The "right" path for you isn't always immediately evident. Carl Jung said, "if the path before you is clear, you're probably on someone else's". But there is reward in the search. You also probably will not find yourself living the life you desire for months or years. That's ok. You can rest easy knowing that you've taken the brave first step of finding your way and there will be peace when it's time to look back at how far you've come.
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