Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘stanford’

Medicine is a Harsh Mistress

“You can have anything. You can’t have everything.”

A rather unlikely combination of players got me to thinking about “having it all”. You know, the perfect job, marriage, home, life. Like Streisand when she sings “Everything”, the life of “I don’t want much, I just want more”. Friday night and Saturday morning were spent in the company of 5 or 6 physicians who  can only be described as “Alpha Females”; this morning’s reading included a piece on Michigan’s football coach, Jim Harbaugh.

What do Harbaugh and my young professional colleagues have in common? Well, they are in the midst of trying to have it all. While these ridiculously successful eye surgeons are more aware of the costs of their quest than Harbaugh, when pushed they are no less apologetic, no less committed to seeing it through to its logical conclusions.

On the surface it would seem that Harbaugh is poised to live a comically outlandish exmple of a successful coaching life. A winning record at a traditionally over-run college program (Stanford) followed by a Super Bowl game in the NFL (losing to his brother’s Ravens), and now head coach at his Alma mater. It’s all so very believable if you read the article quickly, but there it is in the fine print: “…his 14 year old daughter remains in California with her mother, Harbaugh’s first wife.”

Rut roh. A little bit of Heinlein creeping in here.

Much has been written about the plight of the “successful woman”. Indeed, I’ve written on women in medicine and the fallacy of “having it all” (and been quite enthusiastically eviscerated for having done so). My female colleagues sat with me around a table and over wine we talked at length about their lives. How busy they are in their day jobs. How the added time requirements of being acknowledged super-experts in parts of our shared field add to the challenges of being mothers and wives in nearly direct proportion to the gravitas it adds to their professional stature. We were all away from home on a Friday night for a meeting Saturday morning and the privilege of flying home that afternoon.

“N”, a colleague nearly 15 years younger who is also (I hope) becoming a friend, opined that she felt like she was “half-assing” everything except our shared endeavors as subject experts. That she only felt fully successful, comfortable, and in some way validated, in the company of her expert consultant peers. The moment, shared with knowing nods by each woman present, was brief.

Personally, I am late to this consulting game, roughly at the same “level” as colleagues in their mid- to late-30′s (I am 55). Barring some unlikely stroke of good fortune (e.g. I might actually be as smart as I think I am, and someone might actually agree), I will end my career rising no higher than the middle of the pack. Why is that? Well, let’s spend a moment with Heinlein, as my wife Beth and I did when I was ~34.

Just like my very impressive young colleagues, when I was in my early 30′s I was approached to offer insight into the needs and desires of my generation of physicians. Being a male physician I acknowledged the advantage of fewer societal expectations regarding responsibilities outside my career, and the massive leg up from a spouse who left her career behind to run the domestic side of the team. Good, bad, or indifferent, what my wife and I did then was explicitly calculate the cost of that success.

In “The Moon is a Harsh Mistress” Heinlein’s lunar society is run as a nearly pure libertarian experiment, fueled by a single philosophy: There ain’t no such thing as a free lunch. Your mother told you the same thing: there is a consequence to everything you do (or don’t do). What Beth and I did, what Harbaugh didn’t do and what my colleagues only later have done, is prospectively calculate the costs of success in one domain paid out from the accounts of the rest of a life’s domains. Gains in one almost always come at a cost or loss in others. Certain of the effect on our family (despite my gender-driven advantages), the costs to be paid at home, Beth and I opted to forgo the opportunity. For 10+ years the only place I went was home for dinner.

What was the cost to me for having taken myself off the consulting carousel? Who knows? I might have been a certifiable big deal in the world of my day job. For sure, the White family left a lot of money on the table. Harbaugh chose differently and left a 14 year old daughter, and all that represents, in California. My young colleagues, the Alpha Females who are quite rightfully sitting at the table of experts despite their tender years? What will be gained, and at what cost? We shall see…they shall see.

In the end, Heinlein (and your mother) continues to be right, no matter what currency we use to calculate cost: TANSTAAFL.

 

On Football

Randy texted me about the exciting finish to the ND/Stanford NCAA football game. It made me smile. Not the result, not even the topic, but the excitement. A parent is only as happy as his least happy kid, and at that moment one of my kids was very happy. Randy’s football playing days are long behind him, but the game still brings him joy.

Me? Not so much.

Oh sure, there was a time when football never seemed to be any lower on my list of wonderful things than 2 or 3. I was a medium-sized fish in a puddle as a high school football player, but I didn’t have the game out of my system when I graduated. Accepted at one Ivy League school and waitlisted at another, I turned down both because I was too small to have any chance of playing football at that level. Instead I went to a very old, very small school and played a bit all 4 years. Now done as a player I was nonetheless still enthralled by all other things football.

Many of my closest friends were met on the freshly cut football fields of my youth. Wins and losses followed on those fields, most of which I’ve long forgotten. Indeed, I’ve written before that it is only the losses I remember, especially those that resulted from some personal failure in a game. A fumble, perhaps, or a blown coverage. And yet there is no escaping the fact that those countless hours at practice, in the locker room, and on the field are in large part responsible for who I am, the adult I’ve become.

It’s a powerful thing, football. Families rally around a favorite team. Lifetime friendships are renewed and strengthened through shared fanhood. Annual calendars are set only after the team’s home schedule is published. The game itself is exhilarating to both play and watch. At least, it was. I find myself finding all kinds of reasons not to watch football games now. Not consciously finding “big picture” reasons like domestic violence or performance-enhancing drugs so much as tiny reasons, like Beth wants me to tag along to the barn, or Abbie the world’s smartest (and most easily bored) dog would like an adventure kind of reasons. Football of all sorts played at any and all levels has sunken to a kind of triviality, easily trumped by a trip to the grocery store.

No one thing is responsible for this falling out of love, as it were. This fall is different from the last, and the one before only in that it is now glaringly obvious that football holds for me no essential attraction by itself. Looking back my only surprise is that it took me so long. Why didn’t I begin to turn away as my friend the ER doc buzzed through Dan’s shoulder pads with a saw in order to get him into the MRI? Or when I walked onto the field after Randy knocked himself out cold with a helmut-to helmut tackle to force a fourth down, his first concussion? I was still young, still sure that the game would bring my sons what I thought it had brought me.

I see them now, both of my boys, face down and immobile, and I shudder. I started to see them each time I saw a player go down in high school, or college, or the pros. I began to see that I valued those young men nearly as much as my own boys, and I started to notice that the game of football had become The Game. Those entrusted with The Game did not–do not–appear to share my feelings about the players.

The junior high coach carries the star running back to the bench, there to wrap the sprained ankle in the hope of returning him to the game. Junior High! In a high school freshman game, a rout, the first string defense is still on the field in the fourth quarter, the opportunity to play in a game slipping away for kids on the bench who may never get another chance, when the starting safety goes down with a severed spine on a play he should have been watching from the sideline. What was the first string learning at that point in that freshman game? Alumni and athletic directors and coaches at colleges noted for academic excellence openly opine that they cannot win without lowering the admission standards for football players, and just as openly run those kids off the team and out of their scholarships when they are no longer needed to win. The game in the NFL becomes more violent by the week, with ever more gratuitous violence magnifying the carnage wreaked upon the bodies of the players. Ex-pros roam the earth as a kind of walking dead.

When did football become The Game? When did the keepers of the game become keepers of The Game? When did football players as young as high school become little more than a modern stand-in for gladiators thrown into the arena for the amusement of the many and the benefit of a tiny protected few? I’d like to think that there was such a time, an inflection point when it did change, but I fear it has been ever thus. If that is so then I, too, bear some responsibility for what The Game has become. I did not turn away, or turn my own sons away, at the time of my own dawning awareness that The Game and its keepers cared naught for our sons at all, but only for themselves and their respective place and privilege. The ends (get a bigger coaching gig, fill the coffers of alma mater, protect the TV ratings) justify ever more distasteful means (alter transcripts, bury criminal behavior, obfuscate and evade when asking for public funds).

There was a time when my own playing days were long over when I still found myself on edge as the weather chilled and the smell of cut grass filled the autumn air. It was time to get ready to play football. Those days are in my distant past, and I find that I no longer even think about watching, indeed can no longer see myself watching, except as a vehicle with which I can channel the joy of a child who loves football. This may answer “why?”: I can no longer watch a game whose keepers have lost sight of the fact that someone’s child plays in The Game.

One wonders about the parents of gladiators past, when and why they stopped watching their version of The Game.