Perseverance and Focus: Pursuit of the Noble Cause
by Ronald N. Riner, MD, FACC

“Success comes to the lowly and to the poorly talented, but the special characteristic of a great person is to triumph over the disasters and panics of human life.”
-          Seneca, On Providence, 4.1

Disillusionment is frequently voiced about our healthcare delivery environment from physicians and clinicians on a daily basis. Unfortunately, in my travels I hear some of this at very early periods in professional careers – unfortunate for them, unfortunate for patients, and unfortunate for all of us. Many are talking seriously of leaving the profession.

  I am sure many of us know people who have been extraordinarily lucky in life. Some are gifted to have been born into families and lifestyles that they have inherited through the genetic lottery. Some have just been lucky or talented enough to sail through schooling and careers without serious adversity. These people are sometimes envied. We all have a longing for “the good life.” However, most people are confronted in their lives and careers with serious difficulties and adversities. Their hard work, tenacity and perseverance help them overcome their obstacles and impediments. Their fortitude and their perseverance despite the adversities helps build confidence, self-esteem and character even if they are not always totally successful. The “successful approach” is focused on mastering external adversities as well as internal issues intrinsic to the individual.

   In short, the vast majority of “successful people” I have met have confronted and conquered or continue to wrestle with their trials and tribulations. This is what makes them great mentors, coaches, advisors, people of greatness to be emulated.

   Aha, you say, or as one of my colleagues reminded me – But intelligent people need to be able to know when ”enough is enough”. In our crazy, complex healthcare delivery environment where we deal with hundreds of obstructions to our patient care and dictums that take us away from the bedside – couldn’t we and shouldn’t we consider other opportunities for bright people – opportunities and careers that can be just as fulfilling without as much regulation, demand and risk. I suppose the answer is “yes”. Recall the old adage “Life is short – eat dessert first”. However, I’m reminded of another equally profound statement attributed to Marcus Aurelius, “Everything lasts for a day, the one who remembers and the remembered” (Meditations, 4.35) highlighting how transient and short-lived our careers, lives, and accomplishments really are.

On a recent trip to New York City I walked by the New York City Public Library on 41st Street. The library is a magnificent building designed by the firm of John Merven Carrere, one of the Twentieth Century’s most accomplished architects. Some of the most famous luminaries and philanthropists have their names carved into the stone of the building. The opening of the library in 1911 was attended by President William Howard Taft, Governor John Alden Dix and the New York City Mayor William J. Gaynor. The words of Marcus Aurelius make one wonder how many of these people have any of us even heard of or remember. Nonetheless, in their time they were some of the most famous men and women in the world, masters of their crafts and highly idealized “successful” individuals.

   In reality, we are only here for a short period – what makes that time worthwhile? In my opinion, making a difference. Those of us in healthcare have the privilege and knowledge that we are part of a profession that daily forces some of us to undertake life and death decisions or make decisions that may markedly improve the lives of people we treat. We forget this at times when we deal with the hundreds of bureaucratic rules or electronic health records that don’t work, or what seems like a myriad of irrelevant obstacles or items that are unattached to what we consider to be important work. What sustains us in our activities is a focus on the realities of the noble cause and to realize you cannot always personally change external encumbrances and impediments. Indeed, chaos and challenges exist across every profession, every career and job. You can only absolutely control how YOU feel and how YOU approach these issues. At day’s end you fall back on knowing that in healthcare you are working on activities that will likely make a difference in the lives of people. Not everyone can make that statement or feel that strongly about what they are doing – just one man’s opinion. - originally released June 2017

Two roads diverged in a wood, and I—

I took the one less traveled by,

And that has made all the difference.

-          Robert Frost