Scott D. McLean, MD

I’m taking a gap year.

Yes, I think I’ve earned it. Perhaps it’s more like a sabbatical. No, let’s call it a gap year. Such 12-month vacations didn’t become popular or common until I was well past high school graduation in 1973. Back in the early 70s, if you decided to knock around after 12^th grade it was called unemployment. Or didn’t get in to college. Or “My parents have no idea, and if they did I would be in big trouble”-year. 1973 to 1974 was the year of Watergate, American Graffiti, OJ Simpson playing football and not much else. But not a gap year for me.

Instead I went to college, learned to cross-country ski, decided to go pre-med and struggled with Organic Chemistry. Let my hair down. Failed Hindu-Buddhist Thought. The professor was unpersuaded when I explained that my mind was blank. Much better at Shakespeare, William Carlos Williams, Wordsworth, which made sense, at least to me, the mustachioed English major. I wrote poetry, mostly. And mostly badly. The pre-med committee was unimpressed, and their letter of recommendation for the medical schools to which I had applied was succinct. Not … really … unrecommended, but still.

That would have been a great opportunity for a (yes!) gap year. Instead, I taught high school English for a couple of years and tried my hand at being a lost soul for a few more years. During those days I continued to write creatively and thought I could jump into journalism, free-lance, and was catastrophically bad (a trending quality), and rejected the idea of a life in letters because, as I reasoned at the time, I hadn’t done anything. Though I had. But this was probably a way of rationalizing some cowardice about writing.

Inspired to try to get into medical school, I moved back home to Towson and took biology and statistics and chemistry at UMBC for a year, thereafter landing in Boston and working for Dr. Alfred Persson (vascular surgery) at the Lahey Clinic as one of his non-invasive vascular technicians. On my third round of applications, I got one interview, one waitlist, and one letter of acceptance – to the Uniformed Services University of the Health Sciences. Swore to protect the Constitution, commissioned 2Lt USAF, cut my hair, moved to Bethesda and studied hard.

26 years later I retired from military service, by then a Colonel in the Army. I had trained in pediatrics and clinical genetics, final duty station Ft. Sam Houston, Texas. I had lived in Maryland, Washington, South Korea, Virginia, Texas (El Paso and San Antone), and Iraq. Here I shall do some hand waving, because the gaps in the story line I don’t know how to explain, but at least I can tell you I was not, I repeat I was not offered a chance to participate in the witness protection program. Briefly I did work in solo private practice as a clinical geneticist. Tough gig.

For the past 10 years I’ve been with one of the children’s hospitals in San Antonio, institutions that are revered for their ability to change their names and squabble on the rare occasion. Their corporate lives are complicated, and I don’t understand that, but BCM did give me a great decade where I could fold all of my classical training as a dysmorphologist into the rich batter of genomic medicine, teaching students and residents, working with top genetic counselors, writing academic papers, delivering grand rounds – in the latter drawing inspiration from Bob Joy and Dale Smith. Our Division has grown, my administrative and clinical leaders are very supportive, life is great.

So I retired today: January 8, 2024.

What!    Why?

Not burnt out, not struggling to keep up with my field. In fact, I think I’m better than ever. Ooooo, that’s a dangerous idea. Maybe even proof to the contrary. But I’m not tired or tired of my professional life. No one cut my salary. The paperwork and the EMR is not burdensome. Well, maybe a little. OK, EMRs are aggravating, but not enough to say “I give up!”

I want to write.

Of course, I never stopped writing, but not with intensity and conviction and depth, except in my patient histories, which, for those of you who have suffered through reading a Genetics H&P, are certainly epistles and sometimes novellas. But constrained by certain conventions of vocabulary, structure, style, and need.

I want to write now because 10 years from now I won’t have the same energy and, hey, I’m a doctor, and some of my little grey cells (as Hercule Poirot would say) are going to either be fibrotic or suffer the fates of apoptosis. In other words, I need to write now.

I have ideas, but can I do this?

I don’t know.

Maybe.

This next 12 months will be the proving ground. Those of you who are curious about whether an ex-country geneticist can shift this paradigm can follow me.

Right now I’m in Amarillo. Road trip. Update in a week or two.

Like a staff officer would say:

Very respectfully,

Scott