Remember Why You Started
For the record, I still think medicine is the best career in the world. And yes, I would recommend it to my own child without hesitation. We are an empowered profession, trusted by our patients at their most vulnerable. That trust is a gift, and it never gets old.
Gene G. Brown, MD, RPh
AAO-HNS/F President
My youngest daughter, Lily, is a college senior. Pre-med. And just like that, I'm right back in the thick of it. “Dad, can you read my personal statement?” “Dad, does this CV look right?” I love every second of it; however, I won't pretend the familiar tingle of anxiety isn't running right alongside the pride. Those conversations have pulled me back across decades to my own version of this story: the uncertainty, the hope, the singular focus on a dream that felt enormous and just barely within reach. I wouldn't trade the memory for anything.
For the record, I still think medicine is the best career in the world. And yes, I would recommend it to my own child without hesitation. More importantly, what an era to practice. The technological advances that are reshaping our specialty alone are breathtaking—tools and treatments that allow us to extend lives and transform quality of life in ways that weren't imaginable when I started. The science continues to illuminate disease in ways that sharpen our clinical eye and deepen our diagnostic confidence. We are an empowered profession, trusted by our patients at their most vulnerable. That trust is a gift, and it never gets old.
What has sharpened my appreciation lately—both unexpectedly and beautifully—is the wave of young people moving through my practice in various stages of their journey toward medicine:
- Gap year students finding their footing
- College pre-meds logging shadow days
- Medical students on rotation
- And my personal favorites: the ENT residents from our local training program who come through and remind me, without even trying, what this calling looks like in its earliest and most unfiltered form.
One of my gap year students was recently accepted into an advanced practice provider (APP) program. She's scheduled to return to my practice for a clinical rotation this spring, and I can't wait. Watching her journey from an uncertain twenty-something to a confident, accepted future provider has been one of the quiet joys of this year. Hers is just one story among many. Over the years, I've had the privilege of watching many gap year students move through my practice and go on to matriculate into medical school, nursing school, and APP programs. That kind of impact is a reward no reimbursement rate or productivity metric will ever touch.
I'll be transparent: These interactions do something for me that I didn't fully appreciate until recently. They help me forget, at least for a while, about the prior authorization sitting in my inbox and the peer-to-peer review I have scheduled for tomorrow morning. When a shadow student leans in during a procedure, wide-eyed and completely present, or when a resident asks a question that reveals just how deeply they've been thinking about patient care, something shifts. The noise quiets. The purpose sharpens. I remember, viscerally, why I walked into medicine in the first place.
And that memory matters more than I think we acknowledge.
Burnout is real. The data is unambiguous, and the anecdotal evidence fills every message board in our specialty. The prior authorizations, the shrinking reimbursements, the administrative overhead, the scope creep, the documentation burden—these are legitimate grievances, and I've written about them before. I don't minimize any of it. But I've come to believe that one of the quiet accelerants of burnout is the gradual erosion of our original why. When the day-to-day friction of modern medicine accumulates without the counterweight of purpose, the cup empties fast.
The antidote, or at least a meaningful part of it, is closer than we think. It lives in the faces of students who haven't yet learned to be cynical. It lives in the questions of residents who still find the human body astonishing. It lives in the moment a patient's face changes because you gave them an answer they'd been waiting years to hear.
If you’re feeling the weight of this profession more than the joy of it, I want to offer a simple challenge. Contact your local college’s pre-med club or even the high school guidance counselor, and let them know your door is open for shadow days for students interested in medicine or healthcare careers. Attend grand rounds at your local otolaryngology department. Better yet, find a Match Day ceremony and go. Stand in that room. Feel the energy. Let it remind you of who you were before the prior authorizations, and who you still are underneath all of it.
I'll be walking through this application process with Lily with the same nervous energy I carried decades ago, and I wouldn't have it any other way. Those memories are medicine for the physician. They reconnect us to the part of ourselves that chose this career not for the salary or the prestige, but because we wanted to help people. That impulse hasn't gone anywhere. Sometimes it just needs to be remembered.
Wish me luck with Lily. And while you're at it, relive your own memories of the why. It will remind you of your original “why” and who you are—and why that still matters.
