The View From the Tree

I am sitting with my 9-year-old daughter who is happily dreaming of becoming the first astronaut who is also a physician and a musician: she wants to study space medicine and is wondering if she will take her cello or French Horn as she travels to Mars. I am struck by her earnest ambition and her sweet innocence with her excitement and dreams for the future in which anything is possible. I begin thinking about my 50-year-old journey in life so far and start to reflect on my career in academic medicine over the years…

As a young premedical graduate, I am walking through the lush green field of dreams. I see many tall verdant trees around me, and I am drawn to 1 of them: the tree of medicine. But first, I must engage in a fight of the fittest to gain entry to the prized tree. After emerging victorious but somewhat bloodied and chastened, I start to climb the trunk of medical school savoring common experiences with my new friends who become my classmates for life as the batch of 1989. I am bound to my class by common memories of classwork and clinical clerkships with intense experiences and numerous challenging exams as we laugh together with our successes and cry disappointedly over our failures. Every year rings in new opportunities and daunting challenges. Through it all, I remain connected forever with my classmates as I develop my tough exterior to cover up my vulnerable humanity.

I peer up the trunk and start to see the first of many branches into residency and beyond. I marvel at how some of my friends instinctively know where they want to climb to, while I hesitate and take a tentative step on the branch hoping that it will hold for me. Still others follow inspired by their friends and by those who went before them. A few regret their choice and decide to climb down the tree of medicine to experience other trees in life. As I move onto my branch, I gain confidence and begin to enjoy my explorations with my fellow travelers who have arrived with me. I make new friendships and share great joy and terrible disappointments on this exposed limb but take great inspiration from the courage of those who went before me. I reach the end of my branch and now have to decide if I want to move onto another branch. I look down and for a moment I am overwhelmed by how far I have come and anxiously wonder if I will fall down.

I bravely manage my anxiety and excitedly reach up the higher branch of fellowship and join an even smaller elite band of fellow travelers who seek the same knowledge and adventure as I do. I feel connected and yet alone as I seek to define my path up the tree. I pause to occasionally admire where I am but feel that I must continue to climb to the top with the weight of expectations. I encounter many hurdles during this climb and attempt different approaches to overcome these challenges. I wonder if I am good enough to be on this branch, and yet I know that I am capable of remarkable feats through my deeds. I scramble up and come to the end of the branch and now face a new challenge: numerous branches that extend upward and higher with no clear path forward. I pause and take a deep breath and continue to climb.

I find a branch sloping upwards that appears to lead to the top and clamber on not knowing exactly where I am going. Suddenly, I spy an off-shoot branch to my right that is very alluring and appears to lead to nowhere, but I remind myself that I must continue on my chosen path. As I ascend higher, I realize that there is no clear way onward with many dense tangles of thorny leaves and gnarly branches; I decide instead to descend and explore the branch that interested me. I gingerly step on to this branch wondering if it will support me and to my surprise it does! I decide to move further and, much to my delight, I find this branch very engaging and exciting. After spending a good deal of time here, I know that I have enjoyed myself but remind myself that I do not have too much to show for my efforts. Before I turn back, I pause for a moment and admire the views of the vast vistas above and below me. I could stay here forever and happily absorb all that I see. However, I do not want to disappoint those who believe in me and sent me up the tree, so I decide to soldier on to reach the top.

As I turn to go up, I see many who are swiftly climbing straight up to the top. I wonder what it must feel like for them and, inspired by them, start to climb again. As I take a step up, I see another intriguing branch in a different direction beckon to me. I cannot resist and make another detour, and before me lies another remarkable exploration. I take time to study my branch with great passion and savor slowing down in my climb. I again decide to take in the view. To my amazement, I realize that I am experiencing an entirely different view from before. As I turn back, I miss a step and feel myself falling through space. I close my eyes certain that I will fall badly but find myself grabbing a tiny branch that arrests my fall and I pull myself to a sudden stop. I chastise myself for my near brush with failure but resolve to learn from this as I collect myself.

I continue to climb upwards; however, with a certain childish sense of excitement and mischief coming over me, I begin to wonder if I might have a lot more fun just exploring these different branches without rushing to climb to the top. I ask myself what success means to me and how I am trying to define success in my journey up the tree. I reflect and begin to realize that my happiness and sense of purpose derives from these excursions and detours during my climb up the tree, even if I have little to show for my efforts. I think to myself that I just happen to take a longer route up the tree as I stop to explore different branches and admire the view from different sides. I want to bring my daughter up this tree so she can experience for herself my excitement and wonder and maybe even see Mars through a clearing in the foliage. Content and happy, I find myself back in the middle of the tree and see a fellow traveler who asks me how to get to the top of the tree. I smile to myself and start to explain to the newcomer that they can choose any path up the tree but remind them not to forget to enjoy the view from the tree.