‘We All Live Downstream’
How well do we recognize the legacy we inherit from teachers, trainers, mentors, parents, early pioneers in science, or others who have gone before? Whether we speak of our professional life, or our rich cultural heritage, or our political freedom, we stand on the shoulders of giants—of those who blazed the trail or pioneered new ground. To paraphrase the prophet Moses, we all “live in cities we did not build and drink from wells we did not dig.” (Deuteronomy 6:10-11) Is there an implication from this truism for our behavior? Is there a “So what?” buried in this recognition? Besides being grateful or occasionally celebrating or honoring the memory of earlier contributors, mentors, or leaders, are we obligated in any way to act differently or to do something in response to our “inheritance”? I am confident that each of us, without external prompting, would immediately answer with a firm “yes.” I believe this from seeing the pioneering spirit being passed from teacher to student; from my observation of the culture of selfless behavior displayed by our members engaged in humanitarian efforts and teaching; from the incontrovertible evidence of your volunteerism, sacrifices, and leadership in advancing the science and the practice of medicine, and of putting your patients’ needs first. It shows up in how we parent our children in our families and exercise our right of political engagement, which is the heritage of every American, to participate and have a voice in our government. Part of the obligation we inherit to respond to the legacy of pioneers who preceded us, is the development of our own leadership skills and being true to the values that enrich our lives. As a prominent corporate executive, Andrea Jung describes the feeling in her career that, having been passed over for the CEO position at the company she loved and wanted to remain with and lead, she was offered a more lucrative position as CEO of another company. Sensing that she was in a hurry to advance her career, a friend and board member advised her to stay, with the words, “Follow your compass, not your clock.” She loved what her company stood for and the great influence for good it represented. She stated that she then realized that she would prefer to be number two in a company with this positive impact on society than to be number one in another company without it. [True North, p. 154] We live in a time of great change and even uncertainty about certain elements regarding the practice of medicine. There is so much focus on what will be different about our future that we spend too little time ensuring what will not change. Being true to our “compass,” the one that led us to become physicians and otolaryngologists in the first place, we can assure our patients that providing them with the highest quality of care possible will NOT change. We can assure those we train in our residency programs that this is an incredible specialty with a bright future of innovation, service, and personal satisfaction. We can assure our medical students and those considering medicine as a career that the best years for physicians and medicine are still ahead of us. And, most important, we can assure the nation and the world that the profession of medicine can be trusted with the stewardship of continuing to save lives, reduce pain and suffering, and improve the quality of life for everyone. Not long ago, I saw a bumper sticker that read, “We all live downstream.” While the point of that particular message was an environmental one, the greater lesson is likewise about legacy: the impact of the lives of our forebearers, and the inescapable influence that flows downstream from our lives and actions. I join with you in accepting the challenge of assuring that downstream from our actions, our work, and our lives will be the clear, cool, and refreshing legacy of success in establishing better care, better health, and better lives for everyone. I urge you to use the Academy and Foundation to share your expertise, refresh your knowledge, expand your friendships and associations, hone your leadership skills, recharge your batteries, and renew your enthusiasm for this great profession.

How well do we recognize the legacy we inherit from teachers, trainers, mentors, parents, early pioneers in science, or others who have gone before? Whether we speak of our professional life, or our rich cultural heritage, or our political freedom, we stand on the shoulders of giants—of those who blazed the trail or pioneered new ground. To paraphrase the prophet Moses, we all “live in cities we did not build and drink from wells we did not dig.” (Deuteronomy 6:10-11)
Is there an implication from this truism for our behavior? Is there a “So what?” buried in this recognition? Besides being grateful or occasionally celebrating or honoring the memory of earlier contributors, mentors, or leaders, are we obligated in any way to act differently or to do something in response to our “inheritance”? I am confident that each of us, without external prompting, would immediately answer with a firm “yes.” I believe this from seeing the pioneering spirit being passed from teacher to student; from my observation of the culture of selfless behavior displayed by our members engaged in humanitarian efforts and teaching; from the incontrovertible evidence of your volunteerism, sacrifices, and leadership in advancing the science and the practice of medicine, and of putting your patients’ needs first. It shows up in how we parent our children in our families and exercise our right of political engagement, which is the heritage of every American, to participate and have a voice in our government.
Part of the obligation we inherit to respond to the legacy of pioneers who preceded us, is the development of our own leadership skills and being true to the values that enrich our lives. As a prominent corporate executive, Andrea Jung describes the feeling in her career that, having been passed over for the CEO position at the company she loved and wanted to remain with and lead, she was offered a more lucrative position as CEO of another company. Sensing that she was in a hurry to advance her career, a friend and board member advised her to stay, with the words, “Follow your compass, not your clock.” She loved what her company stood for and the great influence for good it represented. She stated that she then realized that she would prefer to be number two in a company with this positive impact on society than to be number one in another company without it. [True North, p. 154]
We live in a time of great change and even uncertainty about certain elements regarding the practice of medicine. There is so much focus on what will be different about our future that we spend too little time ensuring what will not change. Being true to our “compass,” the one that led us to become physicians and otolaryngologists in the first place, we can assure our patients that providing them with the highest quality of care possible will NOT change. We can assure those we train in our residency programs that this is an incredible specialty with a bright future of innovation, service, and personal satisfaction. We can assure our medical students and those considering medicine as a career that the best years for physicians and medicine are still ahead of us. And, most important, we can assure the nation and the world that the profession of medicine can be trusted with the stewardship of continuing to save lives, reduce pain and suffering, and improve the quality of life for everyone.
Not long ago, I saw a bumper sticker that read, “We all live downstream.” While the point of that particular message was an environmental one, the greater lesson is likewise about legacy: the impact of the lives of our forebearers, and the inescapable influence that flows downstream from our lives and actions. I join with you in accepting the challenge of assuring that downstream from our actions, our work, and our lives will be the clear, cool, and refreshing legacy of success in establishing better care, better health, and better lives for everyone. I urge you to use the Academy and Foundation to share your expertise, refresh your knowledge, expand your friendships and associations, hone your leadership skills, recharge your batteries, and renew your enthusiasm for this great profession.