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Of all the prescriptions I filled during my years as a pharmacist, some of the most satisfying were for teenagers with acne.

They often came to the counter with a parent, prescription in hand, already carrying more embarrassment than any teenager needs. In the 1970s, Retin-A was a commonly prescribed treatment for acne. But these young patients needed to know something important: when they first started using it, their skin could become more irritated and their acne might look worse before improvement became noticeable.

Imagine being a teenager, already self-conscious about your face, faithfully using the medicine your doctor prescribed—and then looking in the mirror and thinking it was making things worse.

These poor kids needed to hear what might happen.

So I explained it. I told them what to expect, why patience mattered, and why they shouldn’t assume the medicine wasn’t working right away. I could often see some of the worry leave their faces. Mom or Dad seemed relieved too.

I was dispensing Retin-A, but what stayed with me wasn’t the acne cream.

It was the explanation.

I didn’t know then how much of my working life could fit into those few minutes across a pharmacy counter.

Years later, I left pharmacy for biomedical sales. I knew I was entering a completely different career. I had watched pharmaceutical representatives call on me, and during my interviews, the hiring manager told me that teaching would be an important part of the job.

That appealed to me.

I would need to understand complicated medical information well enough to explain it to someone else. The setting changed. The audience changed. The job title certainly changed.

But something came with me.

I was still teaching, still explaining, and still translating.

More changes followed over the years. I wrote grant proposals. I did copywriting and medical and health writing. Eventually, I began submitting personal essays for publication.

By any reasonable definition, I was writing.

But I didn’t call myself a writer.

That word required something I hadn’t yet earned. Writers had publications. Recognition. Accomplishments. I wrote, certainly, but saying I am a writer felt different.

Then an email arrived from Writer’s Digest.

My essay, “Breakfast with a Ghost,” had received an Honorable Mention in its annual writing competition.

I remember what that recognition meant to me, but not because an award suddenly transformed me into something I hadn’t been the day before.

It allowed me to recognize something that had been there all along.

I am a writer.

Looking backward, careers can seem far more orderly than they felt while we were living them. We draw neat lines between jobs and give each period a title. Pharmacist. Biomedical sales representative. Grant writer. Medical writer. Essayist.

But lives aren’t lived as résumé entries.

The more I look at mine, the less interested I am in the titles and the more interested I am in what happened underneath them.

What was the work beneath the work?

For me, much of it was remarkably consistent. I liked taking something complicated, understanding it, and helping someone else understand it too.

Sometimes that meant explaining a medication to a worried teenager. Sometimes it meant discussing medical information with a healthcare professional. Sometimes it meant finding the right words for a grant proposal. Today, it may mean sitting at my desk with an essay taking shape on the screen.

Different work.

And yet, perhaps not as different as I once thought.

Over the past several days, I’ve spent some time scrolling through LinkedIn. I’ve noticed how many people are looking for jobs, contemplating career changes, announcing transitions, or wondering what comes next.

We use words such as pivot, reinvent, and start over.

Those words can make change sound like we must abandon one version of ourselves and build another from scratch.

I’m not sure that’s always true.

We may not reinvent ourselves as often as we finally recognize ourselves.

A teacher who leaves the classroom doesn’t stop knowing how to teach. A nurse who becomes a writer doesn’t stop knowing how to listen. An executive moving into nonprofit work doesn’t leave behind the ability to bring people together. The setting may change. The title may disappear. But some part of the work travels with us.

So, when we’re wondering what comes next, there’s another question worth asking.

Instead of only asking, What should I become?

Maybe we should also ask:

What have I been doing all along?

What is the work beneath your work?

I once stood behind a pharmacy counter helping a teenager understand what might happen next.

Today I sit at a desk trying to help readers understand what happens next.

The tools have changed.

The work hasn’t.

I thought the journey was from pills to prose.

It could be a matter of recognizing what I’d been doing all along.

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Brad G. Philbrick

A grant proposal writer of biotechnology and healthcare

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