Zoë A Lewis, 65: Live Life On Your Own Terms

Having work-life balance, living a life of meaning and grabbing the opportunities to experience as much adventure as we can, are not the typical descriptors of a medical doctor. It has of late become a profession of tremendous burnout. But what if that career was re-imagined on one’s terms, to fit the life drives of the person, rather than the person needing to adapt and endure the demands of the profession?

The trap we all often fall into is that we have no choice in what we do, we have limited options and are doing the best we can. The truth is that the range of choices we have is probably far greater than we have so far imagined. We all suffer not so much from a lack of options, but from a poverty of imagination. As humans, it is our greatest handicap, and one of the principal reasons we created this publication: to add to the menu of what is possible, that it may inspire reader, contributor and editors alike. It may be that we have all been playing small ball, when just outside of our scope of vision there is something far greater.

When Zoë came up on our radar, we had never heard of a traveling doctor. The world of the physician seemed to us as being tethered to an office, endless hours, and mind numbing paperwork. It may be a secure income, with the ability to help and heal others, but the price tag was steep. She said no to that way of living, and has created her own vividly vibrant life that both embraces the joy she feels in her work with the sick and dying, while also giving her B-side full rein to express fearless exploration of the world around us. 

What is the work that you do?
I am a traveling independent contractor medical doctor, and a hospitalist. I am also a hospice and palliative medicine specialist and work on inpatient hospice units with the actively dying. I’m working in Montana and Idaho at present and I live in Miami Beach, Florida. Most patients are surprised this kind of work exists for doctors, but it has become a huge business with over 40,000 traveling doctors filling staffing voids around the country and countless agencies recruiting them. Recent studies are predicting physician staffing shortages by upwards of 140,000 by 2030 so there is plenty of work.  

Background: Hospitalists are board certified in internal medicine or family medicine and are the attending physicians responsible for drawing up a treatment plan and overseeing the patient’s overall care, from admission to discharge. Every hospital now depends on hospitalists to integrate care with the diverse specialists for the increasingly complex hospital patient cases. Hospice inpatient units are facilities that are utilized for active symptom control for the dying and, most often, patients will expire on the unit. 

Why do you like doing that work?
I preferred the diversity and acuity of hospital work over an office practice. With hospice, it’s specialized care that has a peaceful, certain outcome at a slower pace with a greater presence bedside. Both areas are gratifying as I identify with being a healer/caregiver.  

“The work I do gives me autonomy and that is why I chose being a travel doc over traditional employment, and to avoid burnout”

Working as an independent contractor allows me to thrive with freedom to work when, where, and how often within certain parameters.  The work-travel of course is a lifestyle that can be as exciting as one makes it. I relate to the story of George Clooney in Up in the Air,  who embraced travel as his life choice — his own “cocoon of self-banishment.” The work I do gives me autonomy and that is why I chose being a travel doc over traditional employment, and to avoid burnout. However, the downside to being a travel doctor brings the unfamiliarity of not being on home turf with familiar friends and staff,  no home comforts, very basic hotels for the most part, microwaved food, and the misery of air travel,  added to real solitude and strain on relationships with long distance characteristics.  

What is it about dying people that is so special?
A death and dying doctor on inpatient units is not the doom and gloom one suspects. Dying people with a prognosis of days, often just hours, are as authentic as any human being can be. Despite the fragility and vulnerability of their bodies, their spiritual nature comes into its final full bloom and it’s compelling to engage. They are intense, emotional and have an enormous expressive language.  I have heard poetic oaths of eternal love to a partner sitting vigil bedside, felt the gift of relief when forgiveness and embrace came for a fallen sibling or child. And when it comes to the point they approach final peace, we who experience this powerful visible act of grace as they pass, feel it with reverence. It’s never a trivial moment. While no one has come back to tell us just what was going on when they were passing, dying, going to the next whatever, we hospice persons all have our stories and myths about what is going on. The final days of life are full of gratitude for love given and received.  I am calm and present for them,  because I know it makes no difference how much agony, suffering or struggle one has when they get admitted in the unit approaching death. At some point, with the expertise of the entire team, this will come to pass, the struggles end, and their final peace comes. It is bittersweet work with lots of tears. 

“We can control how to use our work skills, determine how we are best suited to use them, and at our own pace”

What is wrong with the work life of traditional doctors?
Let the statistics speak for themselves: Stress is killing us, and doctor suicides are up.  As a salaried hospitalist-employee from 1995-2005, I simply did not have control of my time, and while our incomes did not increase with proportionality to rising inflation over the past 2 decades, the ability to take consecutive days off, and our total time off, was actually decreased, and our work day increased, and mandatory night shifts were added. It became a real battle to have a healthy rhythm living a doctor’s life while we saw decreased earnings. I figured I needed to make a change for myself when I understood time is priceless and, while we have no control over time, only our awareness of it passing, we should certainly try to manipulate our lives to use our time best for our unique needs and desires. We can control how to use our work skills, determine how we are best suited to use them, and at our own pace. Being a doctor, or any caregiver for that matter, implies you have care to give; you can’t be an empty shell faking empathy, or short out on the mental acuity needed to stay on task when the shifts hospitalists work are 12 hours long, even 14 hours daily when covering for the understaffed shifts. It is a marathon of hours with stretches often up to 7 days in a row. 

Being a medical doctor, or a midlevel, the nurse practitioners that do much the same work load we do, is totally exhausting if you are giving your best and doing it right, temp or perm. It should come as no surprise many doctors and advanced practice nurses have now quit medicine all together, some are suiciding, and growing numbers are moving into temp work to get a handle on their lives. 

“The ability to be both still and directed inwards, or outwards in movement, free-spirited, untethered…is my natural harmony”

You seem to live a very A/B lifestyle, two very different ways of being. How would you describe your B non-work side?
Well, yes, on the one hand I was a very serious, introspective, methodical student, sitting relatively fixed in a spot in deep concentration with some book for over 20 odd years to become a research biologist and then a medical doctor. Work time is also my serious,  being still time. But I have this wild, free-spirited, intrepid, extroverted nature too, and it was hard to tap into that with only a few weeks off a year once I started working. I eventually found out I didn’t want to give that side up either. When I travel, the way I liked to travel in my twenties,  it is bold and adventurous and takes a bit of planning and then a month or two at a time on the road. The ability to be both still and directed inwards, or outwards in movement, free-spirited, untethered, going anywhere, doing anything I seek in discovery is my natural harmony. 

An example: I got into diving and got my advanced open water certification. Despite being a novice, with only a dozen dives under my belt, I pursued untouched and non touristy places like Cardamom Island, where I painstakingly planned to dive the coral island belonging to the Lakshadweep archipelago in India. I had to get there, at that time in 2007, via a cargo ship, the Amindivi, that took 36 hours from Cochin. That journey across the Arabian Sea, a blond American female 50+ something, solo traveler, was an adventure unto itself. I coupled the trip to an Ashtanga yoga retreat in Goa, then two weeks on a posh organized trip with Wilderness Travel to Sri Lanka. At that time it was at the end of the civil war with the Tamil Tigers, and it got sketchy towards the end with bus bombings and the airport got bombed in Colombo, and we had military camped outside our hotel with roadblocks. But, it was a fantasy of delights and wonders all the same. The dangerous aspect of travel is not something I embrace, but I don’t shy away from places that have troubles either. Why, one shouldn’t travel anywhere if you watched local news and fear violence; it is, after all, everywhere. 

Why is it important to embrace a B side now?
A good day always starts with the ideas of: What next? In conversations with the dying, when we discussed life regrets in the hours that we passed together, it was often about their not playing their B side, some never, or not enough, or too late in life. It is a regret that can be avoided with a pinch of courage. It is never too late to ask yourself what else could I become, and take steps to make it happen. I reckon an A/B balance in the modern world is attainable for anyone, if we recognize ourselves, and fill in the puzzle to make our parts fit. My nerdy side says: We know about the duality of potentials in physics; the electromagnetic dual is based on the idea that expressions in one of these will have a directly analogous, or dual, expression in the other. That is mostly true with people too, I think. I needed to reconcile an empty nest of a different sort, in place of family responsibilities, when I did not have children, despite IVF technology, and I chose to balance my work life with my creative, nomadic, free-spirited world of curiosities and adventures. It was my unique puzzle to solve with my unique parts as only my unique nature could dictate.    

“It is never too late to ask yourself what else could I become, and take steps to make it happen”

What is your ambition for the next year?
Along with continuing my travel doctor assignments, I’d like to get into commercial and editorial modeling for a new income source, and for a very different change in pace. I want to represent my demographic: vigorous, healthy, sexy sixty-seventy-eighty-somethings who, like me, demand both physical and mental challenges.  We are generations aging like no other, and I’d like to be part of the campaigns to educate, invigorate, and inspire those younger and older than myself with the next possibilities.  

For something that gives back, I imagined traveling retreats with a yogi-nutritionist and psychologist buddy, to guide people with the sorts of questions I think we found good answers for. I will have more time to work on that project to make it materialize. 

My next adventure has me training with a horse trainer in Davie, Florida with Linus, to be ready for cross country, Inn to Inn, this summer in Ireland. 

Why do you travel?
I want to experience uncommon sensual pleasures and make new friends. My first trip overseas I was 20.  I made it to the major cities in Western Europe, but once on the cobblestones in Rome, Athens, Cairo, my imagination was captivated. Standing among ruins, surrounded by the present day people mingled in the shadows of antiquity was life changing.  I knew with absolute certainty I was going to see this world, as much of it as I could. 60 countries and counting, but my list is still long with fascinating places and people that cannot be imagined justly from print.  One that will take time and effort is the Omo River Valley in Ethiopia with its tribal people, in danger to disappear before long, so I need to get at it.  

“Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbour. Catch the trade winds in your sails. Explore. Dream. Discover.” – Mark Twain

Do you travel alone, and what is that like?
I do. In my mid-twenties, I didn’t waste my breath trying to convince friends that our free time from school or work was best spent traveling to faraway countries unlike ours, and money better spent then seeing the world, not saved for, say, that new car.  I started to travel alone and never stopped. I learned immediately: it’s not a form of solitary confinement! A sincere smile, genuine friendliness in first hellos, these are the best introductions to a next best friend. What I learned traveling alone is self reliance, resiliency, patience, and failures are attempts at success. Rewards come in all shapes and sizes and span all the senses, while enchantment is the first glimpse of the Taj Mahal at dusk.  

Women can easily travel alone, setting up a reputable driver service from the airport and planning the focus to be centered among a community of like-minded, with an activity, sport, or intellectual pursuit, and leave open free time to explore with a new companion at the end. Certainly, at 65 years old I have different needs than, say, at 25, but basically, it’s the same tried and true method to plan and execute a trip. Many of my best friends were met this way. 

“Feeling attracted to something, or someone, be it a person, a thing or interest with invincible passion makes us pluripotent, like our stem cells with the capacity for self renewal”

How do you define the fountain of youth?
At 21, I discovered my version and dispelled the belief that I’m going to lose vitality and vibrance just because I reached another birthday.  21 seemed old to me then, and I promised myself, youthfulness remains with the belief that a birthday — the acknowledgment we age —  just a time marker, nothing more.  

You say that one part of the secret is how you eat, sleep and sexiness. Where do you find your sexiness these days?
Lately the sexiness I’m tapping into is training for cross country horse riding this summer. I am riding this truly handsome athletic horse, a former winning champion gelding warmblood named Linus who was once owned by a local Olympic equestrian. Linus is like a retired vintage Ferrari as far as his skills, while I feel like a teenager all over again, full of promise, as I progress enthusiastically with mine. Feeling attracted to something, or someone, be it a person, a thing or interest with invincible passion makes us pluripotent, like our stem cells with the capacity for self renewal. Neurobiochemistry shows physical pleasures beget all sorts of chemical reactions that lead the body to create an ongoing slew of ‘good neurohormones’, the ones related to sexual reproduction, and perhaps aside from the intense experience of pleasure, maybe I’m reckoning, it gives us the bonus of ageless youthfulness. Perhaps I have been doing what I love, with whom I love, keeping that feeling of being in love with life, most of my life, and it is part of my secret. But whatever it is that keeps the complex compounds of life force juices flowing, to every cell, every moment, life force is undeniably what keeps us renewing.   

That said, I’m clearly not talking about harmful addictions to substances, gambling, food,  etc; we know lots of toxic things also trigger the pleasure centers. But, seems being in love with life is non-toxic and, so far, no scientific studies claim it is harmful.

“I want to age with agility”

How do you feel about the outward signs of aging vs the functional movement parts?
I want to age with agility. The health of your musculoskeletal system, the bones, muscles, tendons, ligaments and soft tissues, are more important than your overall outward appearance. With flexibility and strength, you stand up tall and straight, and walk soundly. Nothing is more damaging to the life span than the loss of mobility. Your mobility also protects mental acuity too and we all want to remain alert and mentally engaged. That is not to say people cannot overcome mobility compromise with disabilities — but that is a different circumstance with different challenges, for certain. Agility can be protected but it requires discipline and a team of professionals. I use a regular chiropractor, masseuse, do specific stretching, use steam and sauna, and go to physical therapy and use the Pilates reformer if I need to heal something. I had surgery for cartilage tears in both knees and my hip, so I understand completely about downtime and overdoing it. Still, if I can jump rope, swim a mile, stay in the saddle for a full day, ski or hike at 8,000 feet, and have the memory to not forget where I’m at, why should I care about a few more wrinkles or saggy skin? 

What is your advice on retirement?
I follow my own advice so feel confident to give it: If you love what you do to earn income,  don’t stop. Instead, try to scale it back so you work at your own pace. If that is not an option, explore new ways to remain purposeful and fall in love with something new. We often feel our job is our purpose in life and retirement sets people off in good or bad ways. To each their own journey of discovery. At some point pre-retirement we set our personal goals regarding the accumulation of assets we feel are needed for security and enjoyment.  But sadly, we don’t seem to set goals for the maintenance of our health and our mojo in the same way. I would urge the start of lifelong healthy habits and targeted exercise to maintain agility, daily stretching and weight training for bone and muscle strength. If you are overweight, determine why and change the bad habits. Taking care of yourself correctly takes at least 90 minutes a day if you include supervising what goes into your meals. A healthy mind-body connection is the most valuable asset we have, and it takes a plan with a commitment to maintaining it. 

“A healthy mind-body connection is the most valuable asset we have, and it takes a plan with a commitment to maintaining it”

What are your feelings on food?
I eat to sustain myself and don’t use food or the act of eating for anything else than to replenish my energy needs. I follow the ‘all in moderation’ mantra. Despite my love of beautiful and delicious food, and herbalicious cocktails and wine, (I lived in Italy for a decade so I can speak of the pleasures of excellent food with some experience), I don’t like the feeling I get after overeating or drinking. It makes no difference if food is from my own table or from a 3-star chef, I avoid overeating since I feel awful when bloated, hungover and, personally, it’s uncomfortable to be squeezed into tighter clothes. While I respect the art of cuisine, the culinary movements that take hold to express creativity, and the sensual pleasure of eating and drinking, divine inspirations included, all the same, consumption of energy — eating food —  is not a replacement for anything in my life that I might be lacking elsewhere.  

It is telling we Americans have a poor relationship with food when 43% of Americans are overweight or obese and the number is growing.  We can’t seem to put a finger on it to help people stop gaining weight. We find reasons or make excuses why they do gain. What drives people to eat when they aren’t malnourished or undernourished? If it’s not hunger to replenish energy or nutrients, but something else craved, the real dilemma to protect their health is to determine what are these unmet needs and deal with them. Being overweight or obese is deadly unhealthy, and that is a loud and clear enough reason to avoid it. 

Skincare Regime

What is your skincare regime?
Never a trace of makeup at bedtime

After using a day’s worth of SPF 50 facial sunscreen doing outdoor stuff, exfoliate using a  facial brush and a skin scrub with lactic acid.

Morning: high-potency medical-grade vitamin A and vitamin C moisturizer
Night: peptide intensive serum plus flavinoids
Every so often for a boost of moisture, I use this Japanese face mask Mitomo Aloe + Cherry Blossom Facial Essence Mask
Alpha hydroxy Toner when I’m more oily
Sunscreen SPF 15 daily

The question is whether you believe any of the pseudoscientific claims products tout. If it really works, then it’s basically priceless if it can combat gravity, UVA/B, and our ego in the mirror. I have been using my current regimen for over 30 years. I put my money on flavinoids and retinol.  

As far as invasive or medical technology, I forgo botox now since it started to wear off after 5 weeks a few years ago. I had a series of 4 PicoWay laser face facials for pigment control and fine lines in 2021 and saw benefits with some skin tightening and it’s supposed to increase over time. 

Supplements

What supplements do you take?
Fresh is best: 

Food source flavinoids are great for the skin and have scientifically proven antioxidant and anti-inflammatory benefits, and lower risk of cancer and heart disease. I get a fresh serving daily, no matter where I am, but also take orals.

Sometimes I juice for a few days with a fast, also when I  abstain from alcohol, and I use brightest colored vegetables and fruits like a handful of carrots, celery, apple, ginger, beets, or pineapple. Fresh homemade juice is essential since the chemicals oxidize as soon as they hit the air; no point to bother with juicing unless you get the nutrients immediately from the source. And if I juice, I don’t eat — the carbohydrate calories in the juice are the energy equivalent to a meal. 

On the road, I freeze fresh spinach and add that to frozen banana and a 16-gram-per-serving chocolate protein powder, to some unsweetened almond milk as my breakfast or lunch when I am working. A single serve mini blender packs easy in a carry-on. 

I take a handful of antioxidants daily and a few minerals, magnesium, and started turmeric a year ago. 

Vitamin B complex when I’m working long hours — but not daily. 

DHEA and Melatonin are replacement chemicals we lose as we age,  so I take them.

81mg baby aspirin when working or traveling to reduce my risk of blood clots when I’m sitting in one place at work, or if any commute is over 3 hours. 

Favs

Favorite books?
I’m a huge fan of Salman Rushdie for novels and read mostly nonfiction — Yuval Noah Harari, Nassim Nicholas Taleb and Malcolm Gladwell are favs.

Favorite streamers?
Aspen Institute and The Economist podcasts for world affairs.

Yellowstone since I am working in Helena, Montana these days and Costner is as sexy as ever. 

What are the 3 non-negotiables in your life?
Authenticity, sincerity and courage. The first two qualities have overlap; both imply being true to yourself, deeply committing to transparency, honesty and genuineness. But one can be authentic and still be a total jerk, while it’s impossible to be a sincere person and be a jerk, so you need to be both. Courage has to do with facing life, unflinchingly, with all its facets, the good, the bad, and the ugly, each taken in stride.