Rock bottom

I’m an internal medicine doctor, board certified. Born and raised, trained in medicine in New York. I’m 30 years old. All my support system is out there. Who made the horrible mistake of pursuing a palliative care fellowship in California when I was diagnosed with a life altering sexual health condition and my finances are in an absolute rut. My girlfriend broke up with me a month ago.

I made the choice to come out here based off feelings and not facts, matched here in December 2024 during my final year residency, and I met/started dating my girlfriend in February 2025. I forgot to put my medical school loans back in forbearance when I was in my last year of residency and my credit score took a hit of 160 points, now I’m at a 575. Loans are back in forbearance now but I fucked up bigtime. And I have a lot of credit card debt, barely any cash (live paycheck to paycheck), and medical debt that’s starting to hit debt collectors.

I hate so much that I didn’t take a good look at my finances and health before leaving for California. I hate that I didn’t call my fellowship and tell them life circumstance have changed, I can’t come out anymore. My siblings told me not to back out when I was considering it back in May (fellowship starts in July) and I listened to them, but it’s not on them it was ultimately my decision. I should have pursued the attending job back in New York. So I’d have my support system and some work on my finances.

Girlfriend broke up with me one month ago. She’s back in New York. We broke up due to a bunch of fundamental differences and she was never a good girlfriend who could communicate, but there was the element of me being in a rut that’s sort of the “I didn’t sign up for this”. I honestly felt like I was actually keeping all my difficult and sad shit away from her, she didn’t know about a lot of it. I was doing my best to be strong for her and continue my confident funny self. But I told her out of trust about my health condition and she broke up with me a couple weeks after. She wasn’t meant to be in a relationship, she didn’t do emotional commitment, she’s someone who clearly wanted to be single in this time of her life. That being said, I do miss her and I somehow attached my old identity of confidence and masculinity to her. So her breaking up with me really pushed my already unstable and performative confident self into more instability.

I can’t stop the fellowship because I’m already 5 months in and there’s 7 months left but I hate the shit I do everyday. It’s so dark and depressing and with everything going on, does not help my mental health. I regret the choice I made. And I have a huge, time intensive research project that I should have started yesterday for me to start moonlighting shifts (for extra money) but I can’t muster up the energy to start.

But I have to finish. It’s symbolic of my credit score if I don’t. It’ll look back on my professional reputation and I’ll take an even worse financial setback. I’m going back to internal medicine hospitalist/primary care when I do finish.

How do I find joy in the day to day? I’m utterly broken and depressed. I stopped pursuing passions (I make music, read, got to the gym) partly because no time (fellowship is so busy) and lack of energy and motivation. My brain is drained, I live in the worst survival mode I ever have, and I’m so overwhelmed. Life is gray and insane to California to pursue a childhood dream that has become a living nightmare.

How do I get my confidence back? My joy? How do I accept that this is where I am now and stop living in the “what ifs” and in regrets? My girlfriend and I are irreparable so how do I not think about her anymore and what she’s doing? How do I still give my all into something I don’t like, find joy in distractions, and continue back on my path?

I’m completely isolated, have no friends or anyone out here, and have become a ball of sadness on my friends and family. I want to stop and be my joyous confident self that I always was before this abomination of a year.

And I want to stop comparing circumstances. Despite being a doctor, I made so many mistakes in my 20s leading me here and I have regrets. Such as my health condition. Everyone in my life is getting married, having kids, getting their money up and I keep comparing. It wasn’t supposed to be like this. But I know that no one is coming to save me and I have to save myself.