Leadership ยท 4 min read
A Letter to My Younger Surgical Self
If I could sit across from the version of myself beginning surgical training, there are things I would want to say โ not to save them from difficulty, but to help them make better use of it. Because the difficulties, it turns out, were not the obstacles to the career. They were the material from which the career was built.
Dear younger self. You are about to embark on something extraordinary โ a career in which you will have the privilege of being present at some of the most important moments in people's lives, of using skills developed over years to restore function and relieve suffering, and of contributing to a body of knowledge that will benefit patients you will never meet. That privilege is real, and it will sustain you through the hardest parts of what is ahead.
On uncertainty
You will encounter clinical situations where you do not know what to do. This will frighten you more than it should. The experienced surgeons around you who seem certain are not, in most cases, experiencing the absence of uncertainty โ they are managing it better than you can yet. Learn to say "I don't know, but I will find out" as early as you can, to as many people as you can. It is not a weakness. It is the most honest thing you can say โ and honesty, in medicine, is a form of patient protection.
On relationships
The relationships you build in training โ with patients, with colleagues, with mentors, and eventually with your trainees โ will matter more than any individual achievement. The mentor who takes time to debrief a difficult case, the colleague who challenges your reasoning with genuine intellectual respect, the patient whose gratitude reminds you why you chose this work โ these are the experiences that accumulate into a sense of purpose that sustained technical achievement alone cannot provide. Invest in these relationships with the same deliberateness you invest in your clinical development.
On the broader world
Clinical excellence is necessary but not sufficient for the career you want to build. The gap between what medicine knows and what it does โ between the evidence that exists and the care that is delivered โ is vast, consequential, and addressable. You have, or will develop, the clinical insight to identify the most important problems in that gap and the skills to contribute to closing it. Do not leave those contributions to others. The patients who need them are waiting.
The career that matters is not the one that accumulates the most impressive credentials. It is the one that solves the most important problems โ for patients, for the profession, and for the field.
Be curious. Be humble. Be rigorous. Take care of yourself with the same seriousness you take care of your patients โ because you cannot sustain excellence in their service if you are depleted. And remember, on the difficult days, that the privilege of this work is real โ that somewhere, today, a patient can move their arm, return to their sport, sleep through the night, or live their life more fully because of what you did. That is enough. More than enough.
๐ฌ What would you tell your younger clinical self โ the single piece of wisdom that would have made the most difference to the journey? I genuinely want to hear yours.