Graduation Musings: Maintaining Purpose Throughout a Career

Last week I was invited to address the graduating class of orthopaedic residents at the University of Texas Medical Branch in Galveston, Texas. The invitation came from Ronald Lindsey, MD, and his longtime colleague, Zbigniew Gugala, MD, PhD. Just 21 years ago, I received my diploma from Dr. Lindsey, who was the chair of my department. I was 31, the year was 2003, I was short on confidence, and I was incredulous that I was about to enter the world as an official orthopaedic surgeon.

When Ron called to invite me to speak to his residents and give some words of wisdom, I decided to frame my thoughts as a letter to my 31-year-old self. What would I tell her? How would I build her up? Could my younger self grasp that my 52-year-old self would be trustworthy and worth listening to?

The 31-year-old me was engaged to a man that I loved, bright-eyed, and eager to get married and start our family. The 52-year-old me is divorced from that man, after sharing 17 mostly awesome years of marriage. Our three children are the loves of my life, they are the very best of both of us and I would not trade any of this for anything.

I see now that 31-year-old me was still learning to be a baby surgeon. I was learning how to learn the art of medicine and surgery. I grappled with the understanding that I would not please everyone, and that putting patients first did not and does not mean always making them like me or the care that is correct for them. I had the hubris of youth, I thought that I would influence the delivery of healthcare and protect my sphere from the encroachment of corporate medicine. The 52-year-old me accepts what I can and cannot change, and has found a niche in a corner of orthopaedic care with the Shriners Children’s Hospital. I get to practice surgery in a mission-based organization that treasures the physician-patient relationship and keeps children and their families as the true north of all that we do.

The 52-year-old me would tell 31-year-old me that I would have the chance to sit in the boardroom of the Pediatric Orthopaedic Society of North America and the American Academy of Orthopaedic Surgery. That I would be president of the Ruth Jackson Orthopaedic Society next year. And that I would have the courage to co-found a movement for change, #SpeakUpOrtho (https://www.speakuportho.org/). I would tell myself that I would find my voice and have the integrity to call out unprofessional behaviors in my beloved profession of orthopaedics and that I would speak from countless podiums about eradicating bullying, harassment, and retaliation from our orthopaedic culture.

I would tell my 31-year-old self that I would find my purpose and my voice advocating for equity and inclusion in surgery. I would remind myself that our patients deserve orthopaedic surgeons of all genders, who represent all minorities, of all sexual orientations, and represent socioeconomic, racial, and ethnic diversity.

Above all else, I would reach back in time to that young woman emerging from 26 years of education, finding her wings to fly the coop, and tell her that it is okay to write her own story. I would tell that young woman to hug her father. To recognize that my dad was working toward diversity, equity, and inclusion in orthopaedics before DEI became an omnipresent aspirational phrase. My father lived for his children and grandchildren. He included me in the boy’s club and instilled a belief that I could be a surgeon and a parent, an orthopaedist, and a mom.

To all of the residents entering the post-graduation world of medicine, be good to yourselves. Be good to each other. Keep your relationships with your patients at your core and patient care as your north star. Find sleep, exercise, and healthy food.

Allow others to cover for you, because the practice of medicine is a marathon and not a sprint. When you lose your way, find your younger self and reconnect with all that inspired you to be a physician. And remember to make that younger version of yourself proud.