As I prepare to return to the operating room and the office, I look back on this ten-week “forced sabbatical” with deep gratitude: gratitude to my surgeon and friend, Christopher Ahmad; to my partners for covering for me; and to my patients whose schedules were disrupted. I am also grateful for the opportunity to ‘rehearse retirement,’ exploring what life might look like 5, 10, or 15 years downstream.
I learned that it is a “Big World” out there filled with opportunities for learning, growth, and impact. In these 10 weeks, I had the chance to hone my Italian, improve my chess game, and take two fascinating courses on Stoic philosophy. I thoroughly enjoyed the time to research and think, which helped drive significant progress on the book that Ahmad and I are writing about Human Performance. And this blog has been a fun opportunity to explore some concepts that often get only fleeting mental attention. I had the chance to travel to Sicily to see family, and to work on projects ranging from innovation in surgical techniques to enhance surgeon preservation, to helping guide the strategy of the Pediatric Spine Foundation during my presidential year with this great organization.
The Price of Mastery: Focus, Sacrifice, and Recovery
The obvious question remains: “How Do I Return?”
My perspective has always been that success—defined by lasting impact, not personal achievement—requires sustained sacrifice and singular focus.
It’s hard to imagine earning a spot at the Columbia orthopedic residency (which takes about 1% of highly qualified applicants) any other way. We have a sacred responsibility to master our craft, ensuring the very best outcomes for children with complex spine problems who deserve all the world can offer. Finally, at some point, do we not have an obligation to contribute to improvements in care through clinical research, quality improvement, and national governance? It’s a massive privilege to do what we do, and we don’t take it lightly.
But all this leaves little room for recovery…
Over the last years, but especially in the previous 10 weeks, as part of our book project, I have interviewed high-achieving individuals on a central theme: How can we best “Sharpen Our Scalpel” to maximize our impact on the world? Specifically, we explored three critical questions for career mastery and legacy: How does one “get in the room,” how do we best “climb the mastery curve,” and how can we approach the end of a career for maximum impact and legacy?
Insights on Mastery and Impact
Their diverse insights into hard work, discipline, and sustained performance offer compelling guidance on how to navigate this conflict. Here are a few teasers:
- General Stanley McChrystal: “The harder I work, the luckier I get; My career has been the equivalent of winning a small lottery several times.”
- Kevin Lobo, CEO of Stryker: “Hard work is a given. Learning agility and motivating people are the next set of critical skills. It is not my goal to better Kevin but to better the institution. If you are a servant leader, you will win. If you do the right thing over and over, it will work out.”
- Jim Loehr, Performance Psychologist: “Talent by Itself is empty. It’s the door one has to open. The critical factor is energy. Early on, career favors workers. Later, it favors energy managers. Raw ability becomes compromised without recovery and link to passion. Your ultimate mission is not about you; it’s about how you treat other people. Mastery requires you to transcend personal achievement and create something bigger than yourself.”
- Mark Rivera, Legendary Musician: “Talent gets you in the house, but it’s the continual grunt-work ethic that gets you a permanent seat in the arena and keeps the lights on gig after gig.”
Renewed Focus
While a singular focus on our patients—both those in front of us today and the “invisible patients” we help through our academic mission—is a prerequisite in our field, I hope to emerge just a bit more aware that strategically saying “no” to select opportunities may ultimately sharpen our focus on what matters most and sustain our impact for the long run.
Over the last 25 years, I have operated on more than 4,000 patients. If I maintain my current hectic clinical pace for another decade, I might reach 5,500. What becomes clearer now, though, is this realization: Our most significant impact might not lie in the sheer number of surgeries we perform, but in the patients we positively impact through contributions to surgical innovation, research, education, quality improvement, and team building. I am so excited to see my patients and families in the office and to return to the operating room where my amazing teams help drive amazing care. Yet, I hope to retain the core lesson of this sabbatical: that our ultimate legacy is defined not only by the people we touch directly along the journey, but also by the many we impact through our mission without direct contact.
