“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” ― Theodore Roosevelt (1858-1919)
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
President Roosevelt’s quote is long, but worth every word. I have a soft spot in my heart for Teddy, since he is my favorite president and my great-grandfather, Anton Buckenmaier, was a Rough Rider. I have been aware of these sage words from our 26th president for most of my career. They have served as an inspiration and guide for critical decisions I have made concerning the direction of my professional pursuits. I would never be so vain as to suggest I could improve Teddy’s profound eloquence in his quote. Then again, I have often summed up the meaning of his words (to appease my goldfish-like memory) when I have had a resident cornered and lecturing. My crass and unpoetic summary of his masterful paragraph: There are those that do and those that don’t.
Theodore’s quote was brought back to mind following a recent conversation with a colleague I once had the honor of calling my fellow many years before. This individual has long since surpassed my academic achievement and has become a medical leader. I feel few things in life are more rewarding for an educator than when a pupil surpasses the teacher. The circumstances surrounding the professional dilemma my former student was facing are unimportant contextually here, I was just pleased to hear from him and flattered that anything I might have to say would still be seen of some value. In short, my young colleague faced the age-old problem of taking the safe road for his career by accepting the status quo or risking the rocky road of being an agent of positive change in an entrenched academic medical system.
The safe road is well known to all federal providers. It involves following all the rules precisely, never rocking the boat and always keeping your head below the trench line. Keeping your head down prevents stray ethical questions from hitting you in the head. I have known so many officers in this ilk during my career. They are cautious and calculating in their decisions, careful not to move too precisely in one direction or the other to always appear aligned with the ideas that seem to be winning. These folks are dependable, consistent, and can be relied upon to support the status quo. Unfortunately, they are often the most vocal of critics when they smell change in the air. This strategy has resulted in countless successful careers and produced many general officers. The safe road rewards its acolytes with praise from superiors, favorable jobs and work schedules, and healthy blood pressure. It is the road I have never taken, and my career is full of scars and bruises to prove it.
Humorously, when my colleague called, he began the conversation by stating, “I already know what you are going to say, but I just want to hear it from you again.” He was struggling with the ethical dilemma of either doing what he personally felt was right or following the collective will of his academic superiors. The former decision would be personally gratifying, but would come at a significant political cost (perhaps the only more vitriolic politics beyond the military is academic politics). The latter decision is expected by the organization. It would likely result in continued unfettered progress up the academic feeding chain. To be clear, there is no ‘right’ answer here, only the answer one can live with.
I believe my colleague called me for the rocky road perspective. There is something innately wrong with my psyche that compels me to pursue my version of correct, regardless of the prevailing wisdom on any issue. Fortunately for my family and me, I happened to be right in the middle of 18 years of war when new ways of thinking were desperately needed. I got lucky. My colleague, sadly, currently has none of these advantages. Nevertheless, he called, and I provided another dose of my “those that do and those that don’t” speech, which he had already digested numerous times. I also reminded him that any decision that puts his family in distress (particularly when there is no war on) is likely the wrong one. If I was able to help in some way on this call, then I am grateful, but I am not worried. He always makes the right decision, and I am confident that will be the case here.
Admittedly, I have a soft spot for a person who commits to a worthy cause, damn the consequences. However, those individuals enter the arena and fight for an idea to achieve some greatness while accepting the wounds that will inevitably follow. Failure for these folks is certainly possible, even likely, yet they push forward anyway. As I travel this nation in our RV TimBuckTwo (TimBuckTwoBlog.com) and read the numerous plaques and monuments along the road, one theme persists: Folks that act on their principles despite prevailing wisdom are remembered. The people that reverberate throughout history are the ones who brave the storm to save lives on the shipwreck, order a charge down Little Round Top with a bayonet when the ammunition is gone, or refuse to sit at the back of the bus because of their skin color. These are just a few of the countless examples of folks pursuing their ideals when prevailing wisdom would have seen them safe and quiet at home.
I have chosen the rocky road, which made all the difference in my career. In many respects, all federal practitioners have made a choice for a less traveled and more difficult journey. I believe it is why so much medical innovation comes from federal medicine when greased with the stress of conflict. Federal medicine is blessed with a preponderance of individuals who self-select for a more complex and challenging road. Like Teddy, if I am destined to fail, I would hope it would be in a situation where I was “daring greatly.”
