Completing my medical training feels far more victorious than I imagined it would. What I assumed to be an inevitable win well within my control instead played out like a football playoff run — suspenseful, calculated, injurious. My championship series began long ago, fueled by the middle school dream of becoming a doctor. The first three “games” in the series — high school, college, and even medical school — felt worthy of the sacrifices required, yielding immediate and tangible results. Holding hands with my 4-year-old daughter, I strutted across the stage to collect my medical diploma, thanking the team of family and friends who helped get me there.
I was on to the “championship game,” and neurology residency was all that lay between me and the trophy. During my football career in college, I had battled back from four ACL tears, squared off against Heisman Trophy winners and 350-pound linemen, and claimed a spot on the All-Atlantic Coast Conference team. With a smug grin of confidence, I entered the medical arena expecting this game to go like the rest.
First Quarter: Intern Year
Driving to work on a dark, icy highway at 5 a.m., I skidded through black ice, bounced off the guardrail, and slid into the median. I opened the hood, checking for damage and calling my wife to troubleshoot, when a distant roar cut the silence. My eyes met the headlights of a Ford F-250 with neon under-lights and a cargo trailer barreling down the road through the same ice patch, now gliding toward me, like a show car on a turntable. I jumped the guardrail within a second of an 80 mph collision, my wife still eavesdropping on the thunder of crushed steel and my probable death. Yet I escaped with my life, by the grace of God, forever thankful that I had only to bury my favorite car. I nailed the twisted license plate to my dining room wall as a reminder of my good fortune. I underwent a planned reconstructive knee surgery and settled into my new morning routine with an hour of rehab, treatment for deep vein thrombosis, a shuttle van to the hospital, wheelchair rounds from 7 a.m. to noon, and a quick phone call to check in on my two daughters and pregnant wife. I graduated to crutches two months later and discovered that the new ACL graft had failed — again. I limped through the end of internship, leaning on the first pregame maxim Coach Cutcliffe had taught me years ago: “When at first the game or breaks go against you, don’t let up — put on more steam!”
Second Quarter: Junior Resident
I was hopeful Advent would bring a season of change as our third child, a son, was born. But the psychosis of sleep deprivation began to permeate everything. Kissing my sleeping kids goodbye each morning and hoping for a chance to kiss them goodnight, I watched my wife hold down every aspect of our lives — feeding the children and prepping them for school, grocery shopping and making meals, laundry, bedtime, and nursing a newborn — all with little aid from her perpetually guilt-ridden husband. My life was an efficient yet fragile machine, and I lived by the second maxim: “The team that makes the fewest mistakes will win.”
Third Quarter: Senior Resident
During the first three months of outpatient neuromuscular neurology, I found myself home for breakfast, dinner, and weekends. Perhaps I had found my calling during this needed reprieve. But I was too soon thrust back to the hospital wards: 13-hour shifts, six-day workweeks, alternating night float. It was predictably unpredictable. By day, I taught interns and oversaw patient care, and by night, appeased a screaming toddler. I questioned my career choices daily, and never more than when my 7-year-old hugged my legs and asked me to quit my job. But quitting medicine was not an option. The third maxim seemed my only way forward: “Carry the fight to our opponent and keep it there for 60 minutes.”
Fourth Quarter: Chief Resident
It seemed my life was falling apart as my wife and I fought with everything inside us to maintain sanity and patience. After several rounds of marriage counseling slotted between morning and afternoon rounds, and a moonlighting position falling through after spending all my spare time on paperwork and drug screenings, all I wanted was space to breathe again. A lucrative job and early signing bonus seemed the only way out of this eight-year-deep financial pit, and even that option failed to inspire me. I vaguely recalled my foregone passion for neuromuscular, for neurology, for medicine altogether.
In the years since my playing days, my mind has replayed a pivotal moment in my final college football game at Duke University. Late in the third quarter of the Peach Bowl on New Year’s Eve, we were the underdogs leading Texas A&M. As Johnny Manziel dropped back to pass with receivers covered, he rushed to the line of scrimmage. I had tripped on a lineman, and as I climbed off the ground, I lunged forward to meet him. I had a chance for a sack, forcing a long third down. A pile of players crashed on top of us and Manziel slipped out of my hands. He scrambled to his left and threw a touchdown pass. The video of this play went viral as the Aggies completed a heroic comeback win, 52-48. It was a long and hard-fought game, but I never could forget that one play. If only I had held on tighter.
Determined not to let this championship slip out of my hands as residency came to a close, I held on as tight as I could. The last-game maxim was stamped in my mind: “Play for and make the breaks, and when one comes our way — SCORE!” Graduation was my moment. I threw a Hail Mary, aka the biggest party of my life in my own backyard, with a DJ, an open bar, and the massive team who had supported us. I drank, danced, sang, and remembered the joy and freedom I had longed for. I sent my wife on a weeklong vacation to Greece as a small token of thanks for staying by my side.
I followed my gut and continued on to fellowship, hoping to once again feel a passion for this job. I soon found joy returning as our family found a harmony that had once seemed impossible. The pass was complete — touchdown. Victory.
In retrospect, the problem was not the work of residency itself. I enjoyed running stroke codes and solving esoteric demyelinating cases. I performed well: elected chief resident, awarded best resident educator, and recognized by nursing staff for excellence in team-based care. The true reason for my misery was that my family suffered. And despite my most heroic efforts, I was still an absent father and could do nothing to change our situation. Never in my life had I felt so humbled. I had to learn to let go.
Is this not true every day in the life of physicians? We step into the clinic each morning not knowing whether we will diagnose a benign condition or an incurable neurodegenerative disease. We are sometimes forced to admit to patients that we have no idea what diagnosis afflicts them. And we cannot control their health decisions or their social circumstances. We are not in control. Letting go can be a hard pill to swallow for high achievers — it certainly was for me. But as my coach often said after a tough loss, “You can’t let the results change you.” So while I hold on tight to my values, my work ethic, my championship effort, I will let go of the results. I will fight to be my best self each day, as a father, husband, son, brother, and physician. And that will be enough.
