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I have been asked to write an “Opinion Piece” for this section of CTSNet especially addressing my thoughts and philosophy regarding a career in cardiothoracic surgery. After cogitating over this assignment for some time, I felt that I could not improve over the thoughts that I put forth in a letter to my son as he was embarking upon a career in medicine at The Royal College of Surgeons.
Open Letter to my Son
Though I am old with wandering
Through hollow lands and hilly lands,
I will find out where she has gone
And walk among long dappled grass
And pluck till time and times are done,
The silver apples of the moon,
The golden apples of the sun.
-William Butler Yeats, The Song of the Wandering Aengus, Stanza 1
Now that you have finished your first year at the Royal College of Surgeons Medical School in Dublin, I hope you won’t mind if I use this opportunity to communicate with you and the membership of the Denver Medical Society conjointly. I wanted to write to you, directly, and I, also, need to share my philosophy as a final President’s Message to the Denver Medical Society, terminating my year in office.
I have reflected over your early years in Denver and compared them with those of my generation. Things were so much easier for us during high school, college and beyond. There was no question about the course to follow for most of us, and (we thought) no options. High school-college-graduate school for a professional career. That was expected. No questions asked. Not so for you and others like you. Yours and your contemporary generations have made all mankind aware of other facets of society that are meaningful. Turbulent times, those, in and following the great Social Revolution of the 60s and early 70s – civil rights, Viet Nam, increased awareness of people and ecology, upheaval in traditional morals – all in their wake gave you so many different challenges and opportunities than we made for ourselves. Along with the challenges must have come confusion, rebellion, the desire to be different – and to be an individual. Perhaps this explains your early choice of a college career in “anti-premed” or “pre anti-father”. I wanted so much to help you and to advise you without unduly influencing you to a lifetime not of your choosing. I felt as if my role as a doctor-father was to play an “arms length” part in your decision-making and, yet, be there when you wanted and needed my support. I believe that when you made your decision to pursue medicine, it was a firm one and one of your own conviction. I believe you have found yourself and, in the process of choosing your medical school, experienced the agony of defeat and the satisfaction of achievement. The quality of education you will receive at Royal College depends (as with any school) upon your motivation. You have the disadvantage (?) of being far from home and the advantage of a fantastically broadening environment of a country and school long steeped in tradition and with some of the giants of medicine as your predecessors – Graves, Colles, Stokes, to name just a few. I hope you take advantage of every educational opportunity offered you on a foreign soil – medical, cultural, and the horizon-enlarging perspectives that accompany travel.
With your career choice and school selection, you have bought some problems:
1. Entering American medicine when you complete your studies.
2. Entering the practice of medicine in the midst of changes of all sorts-trends toward nationalization and socialization, changes in medical education, increased governmental involvement in nearly all aspects of medicine, enormous pressures from various groups demanding (and nearly dictating) changes in the ways medical care is delivered, confrontation with enormous bureaucracy and red tape at nearly all levels of medical practice, frustrations with the problems of organized medicine trying to cope with the complex issues of a changing Society. Surely you must have considered the impact of problems such as these upon your choice of medicine as a career, and it could make the future gloomy at worst and unpredictable at best. However (and this is the main point of my rambling), your future as a doctor is, and will always be, bright. You will always be able to make a living and to survive in spite of obstacles and roadblocks created by various elements of our Society; there will always be a need somewhere for your services; consequently, you will always be able to survive and provide for your family. More importantly (much more importantly) you will always be able to do what one wishes when he is dedicated to the practice of medicine-to provide relief and comfort, if possible, to the sick; to ease the anguish of dying; to support those left behind in time of sorrow; to work happily and comfortably with your associates and colleagues; to teach those who come after you; to always be an avid student, even when you are a teacher; and to contribute to Society in a myriad of civic and cultural ways. The pursuit of medicine with all of its problems today is still a noble profession and a marvelous way to spend a lifetime. We (all of us) must not lose sight of our heritage and the history of devotion of our medical forefathers. This, and the ability to try to serve humanity, is our very basis for existing. We must not forget this when we are up to our ears in modern-day alligators and tilting with political and bureaucratic windmills. Then, in our later days, we will surely “pluck the golden apples of the sun.“