I love being a ”shrink-lady.” (okay, a “psychiatrist.”)

I did not pick it out of a hat. I tried a couple of other medical specialties. The “doctor” part — well, there was never any doubt about that part, really. I mean the idea of taking care of other folks came into my head pretty early on, as did the idea that I was smarter than most other kids, ahead of where I was “supposed” to be.

My family had some health problems as I persevered in schooling. It became evident that doctors had not only status but power over other people’s lives.

I asked my Father-Of-Blessed-Memory early on if this was something girls could do. He told me that when he had been at Harvard, there had been a Jewish woman then who was at Harvard and became a physician. Although I never followed up on her then, I now know that she did much to improve the health of the immigrant population of New York City.

It is a very good thing Father-Of-Blessed-Memory did notice early on that Leona Baumgartner’s medical degree was from not Harvard but Yale — primary rival of Harvard, whom he had always acted like he hated.

Apparently, the “a Jewish girl did it before” argument would serve me later, too. When I told them I wanted to join the army, I reminded them about the Biblical military heroine Deborah, in the Book of Judges.

A Jewish girl was in the army before and did pretty well.

Oh, the years of schlogging through general and orthopedic surgery and neurology until I finally found psychiatry!

Not long ago, a very respected colleague complained to me about someone who delivered her a file cabinet. It had been flawed — seriously dented. She simply could not believe that he had not noticed it was seriously not right.

I told her he had an “employee mentality.” He simply did only what he was paid to do. He had been paid to deliver the file cabinet. He simply had not been paid to assure its quality.

She agreed with me immediately as soon as I pointed out what was going on. I knew I was right because an awful lot of people do think in this way.

I may have thought this way briefly, when I was paid by the hour and working my way through college. When I got my first paid job, filing in the Boston Public Library, I already knew I was heading toward medicine. It didn’t help any that, despite my dutifully informing my employer that my strengths were in science and French language and culture, I spent most of my time cataloguing the Juan Peron collection, which of course dealt with Spanish language and culture and politics.

I am still amazed by the number of people I know, even some patients I know, who ask me for advice on what to do for work. I guess I should be honored that they trust me enough to value my advice. No matter how well I might know them, I can’t offer fast and easy help with this one.

They usually ask about future job markets, or how people who know how to do certain things on computers always seem to get employed and paid well, while others do not.

I have little or no knowledge of these things.

I do know that most people work about eight hours daily.

That also seems to be a fairly normal amount of time for people to sleep.

This leaves eight hours, on the average, for a person to be neither asleep nor at work and to sandwich in activities that satisfy all of their psychosocial needs.

Eight hours a day, or so, for work. Me, I might never really stop. After all, I am writing about my work, doing things related to work, now, at nearly 7pm on a Saturday night.

So why do people ask me about what can be earned easily and will make money? Have they not noticed that happiness doesn’t seem to have a lot to do with how much people make?

People are usually at least a little surprised when I answer this kind of a question with at least one question, maybe more.

What did you want to be when you were little?


When was the last time you were really happy?

It doesn’t matter if you have to go back all the way into your childhood.

What were you doing exactly?

People actually get defensive about the choices they have made that have kept them from following their dream.

I would like to be a (doctor, lawyer, veterinarian, business owner, fill in this blank any way you want) but it takes too long.

I usually roll my eyes heavenward. “If you do not go to school, in five years you will be five years older. If you do go to school, in five years you will be five years older, but you will also be something you really want to be.”

Inspiring stories about people who have chosen education later in life seem to help more than anything I can tell people about myself. Somehow, people persist in believing I am wildly successful because I had more advantages than I realize or describe. I really don’t think it was like that, but I am no good at convincing folks of this.

So I often tell the story of the 52 year old woman who sat next to me in third year medical school in Amiens, France.

She had a successful career as a laboratory technician at the Amiens Hospital Center. She had told me her upbringing was traditional French middle-class. They figured she would marry and abandon the career, but she was divorced and still working.

She had simply decided she was at least as smart as the doctors who ordered lab tests. I can attest she was smarter than most. Moreover, she had a practical way of looking at clinical data that seemed to have come at least in part from having raised a family.

She once told me, with a wink, that being a mother was a lot more like being a doctor than anyone would believe.

I believed her.

She is also the person who told me, “I will be five years older in five years. Maybe in five years, besides being older, I can also be a doctor, which is what I really want to be.”

She progressed through medical school at a snail’s pace, largely because of family responsibilities, as well as continuing her work in the lab. She had about three years left when I got my degree and hurried back to the states. She was one of three people I remember whom I tried to maintain a correspondence with. There was no answer from any of them. She had warned me, to her credit, that there would probably not be time for her to write. After all, she was high-energy and doing much.

Quite often I remind friends and patients that, last time I checked, there was no superior age limit for entering medical school in the great Golden State of California.

Senior learning actually seems to me to be more validated in the States than elsewhere, but I am willing to bet there are other places in the world this can be done.

Sometimes I stretch my arms heavenward, saying “Take my job! Please! Even “moi” has to tip over someday!”

Of course, they usually shake their heads. They say it is simply too much work. But if you love what you are working on, it is too beautiful and too wonderful to be work.

My husband found a wonderful series on the BBC recently that tells the history of the artistic depiction of anatomy. I have not been able to watch it without smiling, without reliving the joy of drawing human anatomy, without having the thoughts I had when I was given a signed certificate of my Hippocratic Oath with little caricatures of great physicians/anatomists/dissectors/surgeons and I thought “Galen, Vesalius, Leonardo da Vinci, … Goldstein …”

Freud said something to the effect that the profession someone follows has something to do with what was missing during childhood. In my case, it was control over the health of myself and my family.

I had hay fever symptoms, and remember submitting to desensitization injections from a caring family physician who explained what he was doing to this inquisitive little girl.

My bipolar parents and brother — well, I didn’t realize much about that until later. But it was primarily my brother’s — more than my father’s – Asperger’s Syndrome that made me wonder how a good person could have behavioral problems, and what was going on in the brain, and that propelled me.

The mythologist Joseph Campbell said people had to “find their bliss.” I really believe the best way to choose one’s life work is to look within, to know and what you are, and what made you become that way. The result can be, for that (perhaps minimum) of eight hours a day devoted to work, a sort of quiet heroism not unlike world mythology. Work, if appropriately chosen, may be the best way to become a hero.

Author's Bio: 

Estelle Toby Goldstein, MD is a board-certified psychiatrist in private practice in San Diego, CA.

Practicing Medicine Since 1981

In her medical career, she has studied in Europe and Canada as well as the USA. She has attended specialty training beyond medical school in the fields of general surgery, neurology and neurosurgery and psychiatry (specializing in psychopharmacology).

Experienced In Many Situations

She has worked in a variety of positions, including:

Medical school professor
General and Orthopedic surgeon
Brain surgeon
Army Medical Corps psychiatrist
Prison psychiatrist
Community Mental Health Center staff
Consultant to a major transplant hospital
Drug researcher
“Whatever It Takes!”

She currently has her own indepenent clinic in San Diego where she is concentrating on what she calls Mind/Body medicine — or Integrative Medicine. Her practice is cash-only, doesn’t accept insurance or government payments, and she operates on the concierge, or “private doctor” practice model to give her patients the absolute best quality of care and the highest level of confidentiality.

Dr. Goldstein’s philosophy is “Whatever It Takes!” Her goal is to do everything possible to solve whatever problem she is presented. This includes seeing patients as quickly as possible — not making them wait weeks for an appointment. This includes making appointments days, nights, weekends or holidays. This includes making house-calls. And it includes using the best, most innovative treatments available — most of which are unknown to standard, mainstream doctors.

Her focus is on transitioning patients away from prescription drugs and onto natural substances. She is also a master practitioner of Emotional Freedom Technique, a powerful and dynamic form of energy psychology that usually brings quicker results than traditional psychotherapy.