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Emergency Medicine News:
doi: 10.1097/01.EEM.0000437846.45506.3a
After the Match

After the Match: The Wish List

Cook, Thomas MD

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Dr. Cook is the program director of the emergency medicine residency at Palmetto Health Richland in Columbia, SC. He will begin writing a monthly EMN column, “After the Match,” about residency in July.

Prelude: “We collect Golden Stripes.”

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“What the heck are Golden Stripes?”

“It's the reflection the sun makes off the water as the sun sets. We love to see them together, and we want collect as many as possible during our lifetime.”

Act 1: Every fall our interns come to my office for their first evaluation by the program. They will go through this process no less than six times during residency, but that first one is always nerve-wracking. Most have no idea of how they are really doing, and now they have to sit in a room and listen to what attendings and peers think of their ability to care for the sick.

They are still not entirely sure how to act around me. Some show up in shorts and flip-flops (not so good), and some come in a dress shirt, tie, and sports coat (flattering but not necessary). But just to loosen them up and make the meeting more interesting, I throw them a curve ball, and ask them to tell me what they dream about doing with their lives. I ask them for their wish list.

What does this have to do with becoming a doctor? Well, nothing or everything, depending on your point of view. A program director's primary responsibility is to his residents. Yes, there are lots of forms and checklists and letters that I will write on their behalf, but I have always told applicants and residents that my primary responsibility is to help them become successful on their own terms. I don't mean just professionally but in life. After all, smart, hardworking young men and women in the richest, most powerful nation in the history of the world should be able to do this. If not them, who?

I also tell them, however, that they may not always like me or how I run the program, but that they should always know that I will consistently take the long view on what they need to do now that will make them happy and healthy at 50. That's not to say they do not have fun during residency, but fun at 27 should not take precedence over achieving the goals that will satisfy them for a lifetime.

I ask them to write down a list of things they want to do in life to help me understand where they want to be. But I go one step further and take off all the restrictions. I want them to really cut loose, and give me every crazy idea that runs through their heads. What I get back from them is inspiring.

Of course, lots of the wishes are boilerplate comments about supporting families, paying off debt, owning homes and land, giving back to the local community, and being a good person and doctor. But then I also get the cool stuff that makes a program director's job fun, and my goal is to take these comments and make them real. So I thought I would share just 50 of the wishes I have received from our last three classes.

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The Grand Finale

1. Own a Subway or Zaxby's.

2. Own a winery.

3. Ride in a hot air balloon.

4. Get SCUBA certified, and dive the Great Barrier Reef.

5. Sail around the world.

6. Work for a season on the Yosemite search-and-rescue team.

7. Kayak from Alaska to Seattle.

8. Climb the Nose on El Capitan in one day. (Photo.)

9. Climb in the Wind River Range in Wyoming.

10. Bike across the country.

11. Live in an off-the-grid cabin in the mountains.

12. Learn to play the banjo.

13. Visit interesting landmarks in all 50 states.

14. Be an NHL team doctor.

15. Travel on an eastern African safari with my parents.

16. Grow an orchard.

17. Own a horse in the Kentucky Derby.

18. Provide regular medical care to a community in Central or South America.

19. Go on an international medical trip to Cuba during residency.

20. Have twin boys that will be tandem linebackers for the University of Georgia.

21. Retrace my grandfather's path through Europe in World War II.

22. Live on a sailboat in the Caribbean, hopping from island to island and working short stints in local hospitals.

23. Start a company with physicians backpacking through remote villages on a regular schedule to provide continuity of care. (Paul Farmer meets Backpacker magazine.)

24. Attend sporting events in every major league baseball park and every NFL stadium; attend the Super Bowl, the NCAA Final Four, the Rose Bowl, the Kentucky Derby, the Masters, and the U.S. Open.

25. Half Ironman triathlon during residency and full Ironman triathlon after residency.

26. Medical mission trip to the Himalayas.

27. Go to Brazil for the World Cup.

28. Marathon in less than three hours.

29. Become a medical news correspondent.

30. Learn ballroom dancing.

31. Live in South Korea.

32. Get an MBA or economics degree.

33. Skydive.

34. Start a company.

35. Throw out the first pitch at an Atlanta Braves game.

36. Own a bar in Dublin.

37. Ride in a fighter jet.

38. Collect every bottle of Kentucky Bourbon and open a bourbon bar.

39. Climb one of seven summits: Aconcagua, Denali, Carstensz, Elbrus, Everest, Kilimanjaro, or Vinson.

40. Take my dad fishing every year in Sudbury, Ontario.

41. Take my kids fly fishing in Montana, Colorado, Wyoming, Chile, and New Zealand.

42. Raise my family in rural Africa.

43. Dive on 100 reefs in the world.

44. Hang glide in the Austrian Alps.

45. Go on a Mediterranean relic dive.

46. Work part-time as a rafting guide.

47. Yearly paddle trips in extreme locations: Alaska, Galapagos, Baffin Islands.

48. Rebuild an old VW with my father.

49. Build my own mountain cabin.

50. Buy a ticket to fly in space.

Click and Connect! Access the links in EMN by reading this issue on our website or in our iPad app, both available on www.EM-News.com.

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FastLinks

* Watch a video of Dr. Cook's past trip to China at http://bit.ly/153OPaW.

* Visit EMN's Going Global blog, written by residents in Dr. Cook's residency program at Palmetto Health Richland, at http://bit.ly/EMNGoingGlobal.

* Read of all Dr. Cook's past columns at http://bit.ly/CookCollection.

* Comments about this article? Write to EMN at emn@lww.com.

© 2013 by Lippincott Williams & Wilkins

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