Letter from the Editor: We Have Thanksgiving, but How About a “Return to Idealism Day”?

December is synonymous with two things in academic otolaryngology: faculty looking for open OR time for patients who have met their deductible and want to squeeze in their elective surgery, and residency interviews. For the past 25+ years, otolaryngology has been  one of the most competitive specialties to match. Each year, brilliant fourth-year medical students travel around the country with the singular goal of becoming an otolaryngologist.

This year, there are over 500 applicants for some 300-odd positions, and nearly all would make fine otolaryngologists. You will be pleased to know that your future colleagues are bright, driven, emotionally intelligent, extremely well-rounded, and truly interesting. Not only do these students have outstanding grades and board scores, but some have been Olympic athletes and many have played Division I college sports. There are poets, fiction writers, musicians, artists, and hip-hop dancers. Some have had careers in business or law prior to going to medical school, and others have started successful companies or hold multiple patents. Nearly all of them have volunteered at free medical clinics, gone on a global mission trip, and mentored underprivileged students. And there are incredible stories of applicants who have been raised in limited-resource environments, who against severe odds have made the best of their situation and are dedicated to becoming an otolaryngologist who gives back to the community they grew up in.

Conducting these interviews is inspiring but also sobering. I’m pretty sure I used to look at the world the same way they do now. I was idealistic, looking forward to the challenges that lay ahead and positive I was going to make an impact on my local community. I was hopeful I was going to change the world. But 25 years later, I think much less about changing the world and more about what I need to pick up from the grocery store or the charts I have to finish after a busy clinic. A question I often ask myself after these interviews is this: Why do we lose our idealism as we age?

For doctors, it usually starts with residency. The work is emotionally and physically draining. We round in the morning, take care of patients during the day, and take emergency room call at night. Many of us get married and start families. Once we finish training, the car and house we always wanted become attainable and the drive to make money to afford those things kicks in. As we progress, our children’s schooling dominates our lives, health issues can become problematic for ourselves and our loved ones, and our time to think outside of work becomes limited. But does this always have to be so?

The musician Bruce Springsteen has had a wonderful career. And he also has been very thoughtful about his impact on society and his moral obligation to use his platform to advocate change for good. He has said: “The great challenge of adulthood is holding on to your idealism after you lose your innocence.” He also has another great quote: “It’s not the time in your life, it’s the life in your time.” 

I love the Boss’s music, and I love his quotes even more. Thanksgiving is a time we say thanks to our family and friends. But I think we should also have a “Return to Idealism Day,” where we think about the passions of our youth and how we can pay homage to those ideals within the context of our busy lives. Our work isn’t just about filling OR block time and seeing enough patients to sustain a desired salary. We should ask: Can I carve out the time to volunteer at the free medical aid clinic? Am I being a good enough mentor? Is the procedure I am offering really the best treatment for that patient? Am I making an impact on my community that goes beyond individual patient care?   

For me, residency interviews are special days to soak up the fresh enthusiasm and re-energize. For those of you who don’t get to interview residents, come to a Triological Society meeting and meet these amazing young people who are going to lead our specialty for the next generation. And for the medical students and residents who are reading this, don’t forget who you are and what got you to this time and place. As we age, we need to work harder and with intention to hold on to the passions and ideals that started us on this wonderful career path. 

Thanks for reading, and I look forward to connecting next month. 

—Alex