I recently received a gigantic employment packet from the New York City medical institution where I shall soon be a fellow. The postage on the envelope was over ten dollars.

Inside are many, many sheets of paper, many of which I must fill out with many details about my demographics, health, and credentials. In order to receive clearance and work for this institution, I must do, amongst other things, the following:

• submit a notarized copy of my medical school diploma
• submit another set of medical school transcripts
• send in two letters of recommendation (… even though I already submitted three with my original fellowship application)
• send in a copy of my curriculum vitae (which still falls under the category of “curious and colorful”, not “academic and illustrious”)
• send in a completed physical exam form (though physicians routinely read each others’ tuberculosis skin tests, a complete physical exam isn’t something I want a doctorly friend to do for me…)
• proof of immunity to various infections (rubella, rubeola, etc.)
• go to the local lab so I can undergo a urine toxicology screen (I’ve never had a drug test before…)

Included within the tome was a schedule of required activities. Alas, the date of my graduation ceremony here in Seattle is the same date as a mandatory orientation/form-filling soiree in New York City.

Both choices have notable consequences. Attending the orientation will help me manage my anxiety about my new job. Attending graduation will help me manage my sadness about finishing my old job.

This really isn’t about work. This is really about change. And the obvious lack of control that goes along with it.