Editor’s Note: This is an inspirational and uplifting account filled with wisdom.
“Go find out.” These were the words my instructor said to me when I was a senior resident. This led me to a career which included research as well as leadership.
He and I cared for a patient with a complex calcaneal fracture. We approached it using the currently favored method but were unhappy with the result. We sought to do better.
I asked how we could do better and my attending told me to find an improved method to use in the future. My quest began with long hours in the library. After a fruitless search, I returned to him and said, “I can’t find the answer, so tell me.”
His response was, “I meant: Go, find out! Design a study, it’s called research.” Look at the facts and our experience and think about the small incremental questions that must first be asked and answered. He said, “It is our personal responsibility to find where the gaps in knowledge are and then find solutions.”
So we set out on a journey: I studied anatomy of the hindfoot and the soft tissue envelope, calcaneal fracture patterns, wound healing, and the data about each.
As we looked at the resulting body of work, we found some answers and then formulated more questions. Over time, our philosophy about treatment changed and so did our approach to patients with similar injuries. I learned that it was not necessary to obtain a grant or to be an academician to study and find a solution to a problem.
Together, my instructor and I came up with a new incision. Through it we could reduce and stabilize the calcaneal fracture without greatly traumatizing the surrounding soft tissues. After putting in the work, we had developed our own technique, and it proved successful.
Through this process, I had become part of my attending’s “team.” I don’t think he paid any attention to the gender of his team members. It made no difference to him. We all had a role to play. We identified problems requiring answers and sought to address them. By the end of training examinations, the women and men on the team did equally well. We had all been “elevated,” not excluded.
My training in clinical research was a turning point for me. It readied me for clinical leadership. Using some of the same research methods, I sought to identify the small things in the clinic practice environment that needed change and worked to fix them. This got people on board with me. We started small and moved forward as a team creating change bit by bit.
Some of this leadership work has been applied to teaching residents. I seek to develop a “team ethos” where we have conversations both in the workplace and outside it. Rather than talking about our day in the operating room as we walk down the hall afterwards, I like to move the conversation to a more relaxed social environment. There, we can debrief and discuss the positive and negative aspects of the day. I can make eye contact and evaluate how my message is being received.
This also teaches the resident about how to speak empathetically with patients and their families. The approach lets them know that we are working as a team on their behalf. We seek to engender trust.
What has this story about my research and leadership training taught me? Be interested in other people. Anytime you are around a table, be genuinely attentive to the viewpoints of those sitting with you. Listen and learn.
Would I do my career over again in the same way? Yes, in the main – with hindsight there are always a few things you might have done differently, some slight turns on the road that you missed because you did not look … I am glad that our system at that time did not encourage early super-specialization. This allowed me to broaden my perspectives and skill sets and to learn from others. I wrote many research papers but in retrospect, I should also have sought out and completed an advanced degree to bolster my credentials as an author and researcher. With my scattergun type approach to life, there are always some projects that were left half done – and that is a shame -some of them were quite good ideas!
What is my advice to others?
- If you think problems are huge, they will be. Instead, approach them as molehills. That way you won’t be tempted to give up before getting started.
- Be brave and be prepared. When in doubt, prepare harder.
- Display empathy with patients. Let them know you are working on their behalf.
- It’s not necessary to give up personal goals such as having a family for the sake of your career. Everyone has their own priorities. Events in life cannot always be predicted. Make the most of them.
- Mentors are valuable, especially in early practice years. Embrace them for your benefit. Great mentors can be found practicing in other medical or surgical specialties, not just orthopaedics.
- Leadership positions are rewarding.
- As a leader, try to develop a “team ethos.”
- Embrace diversity, especially in trainees. Exclusion is cruel and toxic.
- I feel privileged. My training and career experiences have been positive. Find and acknowledge your own.
