Perspective on a “speed limit” birthday

There are speed limit birthdays throughout life. They are times for us to take our foot off the gas, check the speedometer, maybe pump the brakes a little and make sure we’re still going the direction we intended. (We may also look around and make sure someone didn’t notice that we weren’t going too fast!)

This month I hit one of those speed limit birthdays. As I thought about this point on the journey, I found myself with a list of things I wish I could reach back and tell my younger self at similar, significant mile-per-hour moments. Here is a short list of some of what I wish I could say:

1973 – 15 years old.
High school -> college

• Don’t be in such a hurry to get to medical school. Life is more than the next rung on the ladder. (It is going to take you most of your life to figure this out.)
• You don’t need everyone to like you. Some just won’t. And it’s OK.
• When your Dad tells you that he doesn’t care what you do as long as you’re the best at whatever it is, he doesn’t mean you have to be better than everyone else. He just means for you to be the best you can be. (It will take you most of your life to figure this out, too.)
• You are going to take a lot of decades trying to lose the sense that you continually have to please your mother. She is already proud of you. You might as well get started on working that through.
• And be nice to that cute girl you met in American History class. You are going to spend the rest of your life with her.

1983 – 25 years old. Married three years. 1 child. 1 on the way.
Medical School -> residency -> practice as a general pediatrician

• Be more present with your wife. This life has already been a challenge. She just doesn’t complain about it. (You don’t see it yet, but she won’t ever really complain about anything.) Always remember that when she was a child, she didn’t want to marry a soldier or a doctor. And she ended up with someone who did both for most of your life together. (You will also learn in time that she is as much of a healer with the heart of a soldier as you are.)
• Savor the stories of your patients and friends. That is what endures and what you will remember.
• Remember that every encounter listening to a patient or family member makes you a better physician.
• Be quick to listen, slow to speak. Ask more. Tell less.

1993 – 35 years old. Married 13 years. 5 children.
Fellowship -> practice as a pediatric pulmonologist & PICU Director

• The move overseas was really hard on your family – wife and children. Pay attention and ask how they are doing. (You really should have asked more about how they felt before you moved from a place they loved and were thriving.) Listen to what they say about how they feel. And when you want to do stuff or feel you have to, don’t trot out “Duty to patients/country” or “God’s will for our lives.” Even if they’re true, they are dirty tricks that make it tough for people to talk about how they really feel. They may grow to resent them.
• Remember that not everyone is as pathologically optimistic as you are.
• When you say you’re going to be home be there. Do whatever it takes to be present and really paying attention. You are going to regret every moment you weren’t tuned in when the kids are no longer around to toss the football, share a birthday breakfast or go to the beach with you.
• Play dolls with your daughters when they ask you.
• Be much more careful of the message your children are picking up about shame. Don’t put your phobias and angst about adolescent sexuality on them. They are far more mature and competent than you give them credit for and the shame is going to be a challenge for them to shake.
• Take time to grieve the losses of your patients, friends and family. You are going to wish you did. When you don’t take the time you will eventually lose the skills you need to grieve. It is a useful capability in the ICU when there are other patients to care for. But it can be a handicap in life.

2003 – 45 years old. Married 23 years. 7 children.
Pediatric Residency Director -> Department Chief -> Deployment

• Remember what your mentor said when you became a Lieutenant Colonel, about how everyone will tell you that you’re going to be a general someday to get you to do the  jobs that no one really wants to do. You’re not going to be a general and you won’t regret it. You’re going to realize how much being in hospitals and around patients really means to you. So don’t worry. Eventually there won’t be any more brass rings and it’s alright. You only have so many fingers. (Spoiler alert: You’ll never have a job that you didn’t love!)
• Trust your team and listen to them. Don’t expect them all to think and see things the way you do. In fact, you don’t want them to. This will become a secret of success in health care leadership: Some of your most outspoken critics – whose heads begin to swing “east-west,” shaking back and forth as soon as you introduce a new idea – will be the ones who contribute the most to keeping the ship moving forward and in the right direction.
• Look in your people’s eyes every morning. That’s the most important function of a daily huddle or morning report. Do it often enough and you will know them. And there isn’t a better gift you can give them as a leader. Do the same at home. It’s also the best gift that a husband and father can give.

2013 – 55 years old. Married 33 years. 2 children still at home.
Hospital CMO, COO, CEO -> “Retirement” and transition to a civilian world

• You’re not as important as you think. Get over yourself. In your former life, everyone instantly answered your email because of your position and not because it was from you. And it’s OK.
• You are used to being up front and it’ll be something you need to unlearn. There are still teams to help lead but from the back and from the sidelines. You’ve had your moment. It’s time for someone else. They need your insight and support.
• There are still fights ahead. You have no idea. (Think multiple global health emergencies.) Pace yourself.
• Don’t scoff too quickly at the idea of ultimately (and really) retiring. It won’t strike you as silly in a few years.
• Your mom was proud. Your dad knows you did your best. Let them both rest with that. You rest with it too. Your children all feel the same way.
• That girl you met in high school American History class, dated in college and married a month before you were accepted to medical school with three days’ notice is inexplicably still with you. Rejoice in the bride of your youth.
• Life’s not a check list. When you stop at a traffic light on your bike, notice the flowers and the clouds.
• The best years are still ahead. Ad gloriam Dei.

Chuck Callahan Henry V 4.3 – Lead from the Front   https://henryv43.com/