It is a Friday night, and I am sitting in my apartment on day 5 of the 7 days of my inpatient chronic pain service call, the second of 6 of these weeks I will complete this year. I must admit, as a newly minted anesthesiologist 5 months out of residency and into my interventional pain medicine fellowship, taking call from home is better than in-house call. I remember the small, cold call room, old twin mattress, and the hospital food. Nevertheless, I am on call and will need to go into the hospital to round early in the morning. My wife left town earlier today to spend a long weekend with her family, and there are few options for me on this Friday night.
Given this situation, it may be natural to drift into feeling sorry for myself. I need a quick tune-up—something that will provide a reset, that will reinvigorate me and remind me why I chose this career. I turn on the television and go to my saved shows on TiVo. Tonight will be the fourth time I watch the same video. It is the acceptance speech Jim Valvano gave when he won the Arthur Ashe Courage and Humanitarian Award during the 1993 ESPY (Excellence in Sports Performance Yearly) Awards.
Jim Valvano was a National Collegiate Athletic Association (NCAA) basketball player and later the coach who led the North Carolina State men's team to an improbable win in the 1983 NCAA Championship game. A year before receiving the award, at age 46, he was diagnosed with cancer. At the time of his speech, it had metastasized throughout his body, and 2 months after receiving the award, he passed away. His speech that night carried profound meaning to many people, including me, spoken by a great man who knew that the time left in him was limited.
“To me there are 3 things we should all do every day. Number 1 is, you should laugh. You should laugh every day. Number 2, you should think. You should spend some time in thought. And number 3 is, you should have your emotions move you to tears. It could be happiness or joy. Think about it, if you laugh, you think, and you cry, that's a full day. That's a heck of a day. You do that 7 days a week, you're going to have something special.”1
Given these words, it makes sense that this is the fourth time I have watched this video in the last several days. I am sure on the surface the connection for me is the tie to the medical world—later in the speech Coach Valvano announced the start of the V Foundation for Cancer Research, which to date has raised more than $200 million. He was the first recipient of the Arthur Ashe Courage Award, created by tennis Grand Slam champion Arthur Ashe, who contracted HIV from a blood transfusion and founded the Endowment for the Defeat of AIDS.
But it is more than that. Watching Coach Valvano speak with such fire and enthusiasm, while he is dying from terminal cancer, I cannot help but get emotional listening to his words and watching the passion. His speech is only 10 minutes, but every time I watch it I find myself feeling emotional, and then recharged and refreshed. Suddenly, I'm not feeling down about being stuck at home on a Friday night.
Later in his speech he notes, “The most important thing is to think in 3-D—where you started from, where you are now, and where you are going to be. Those are 3 things I try to do every day. I remember where I came from. It's so important to know where you are. Right, and I know where I am right now. How do you go from where you are now to where you want to be? And I think you have to have an enthusiasm for life, you have to have a dream, a goal. You have to be willing to work for it.”1
Medical training is long and grueling. There are peaks and valleys, but it would be valuable for every trainee to have a well of motivation to access quickly. It doesn't always have to include talking issues through with a significant other or friend, or taking a “break” by going to a restaurant, gym, or the movies. It can be a brief visit to a well, the sort of emotional fountain you can access quickly when you need a boost. If all trainees had a well like this, perhaps the “dog days” of residency or fellowship would be fewer or less taxing. During these tough times, we lose sight of the bigger picture—how lucky we are to be physicians, to have the ability and opportunity to become proficient doctors, to use our skills to help others who need it. It is not that we forget, but the day-to-day can start to wear us down, and during these times we must remember where we started, where we are now, and where we want to go, and rekindle the enthusiasm and the dream.
The words Coach Valvano spoke 24 years ago ring true today. If every day we can laugh, think, and have experiences that move us to tears, that's a full day. For me, watching his speech accomplishes all 3 of those things at once. To the individuals who have taken the time to read this, I have 2 requests: First, watch his speech and embrace the emotion. Second, find your well. Once you find it, go to it often, as often as needed, because residency is a long road. We can all use a touch of reinvigoration from time to time.
