Staying hungry

I’ll open by saying that stagnation and lack of motivation are not currently an issue for me professionally- if anything, it’s sorting through these choices that I have made (and all of which are important to me) and not feeling overwhelmed. Staying motivated and feeling listless about how I contribute is not a struggle…right now.

About six weeks ago, there were nearly simultaneous pieces in the HBR and the Chronicle of Higher Education discussing what happens once we achieve something that’s been the brass ring for a length of time.  For many of us in academia, it’s that day when we find out that we’ve been promoted and received tenure.  For my friends in the business world, it’s a big promotion; for attorneys, it’s achieving partner.  You get the idea.  There’s this thing out there- whatever it may be- that represents high achievement in our professions.  So, we get there.  Then what?

In my usual “completely honest” fashion, I suffered from post-tenure depression.  After spending the first several years of my career in academic surgery trying to episodically balance inquiry/ publication, teaching/ education, clinical work, and administration in a fashion that kept me on the pathway to promotion.  And I did wake up thinking, “What now?”  I also realized that, quite honestly, I was tired.  Not completely exhausted and depleted, just tired and in need of a recharge.

After wallowing in this for a bit and wondering if this was finally my chance to become lazy, I woke up one day and realized that the whole point of tenure is to have academic freedom.  So much for that lazy idea…but hooray for being at a point that allows me to choose what my next great work will be.  I’ll also admit now that I’ve settled into this role in the last couple of years (and have used my “security” to pursue work examining disruptive surgeon behavior and the status of women in academic surgery, both using qualitative methods) and have realized that if anything it’s harder.  I have a greater need for time and space to think; I have more difficulty finding that time and space.  My goals are less set for me; I have more opportunities to seek broadly.  Most importantly, it’s my responsibility to stay hungry- no one else can provide that internal drive and inherent curiosity that is ultimately required to make a difference in our profession or in the world.

Right now I’m in the process of changing up how I do my white board in my office.  I’m working on embracing my productivity style as a “visualizer” (no wonder OmniFocus was such a dismal failure for me!).  I’m embracing new roles and responsibilities that require my very best leadership and more creative problem solving than I anticipated.  I’m writing my mentors thank you notes because I realize what a challenging role that is.  And right now, even though it’s a bit late, I’m going out for a run.  It’s time to clear my head.

Is tenure making us irrelevant?

First, a disclosure:  I am a tenured surgery faculty member at the University of Utah.  That said, I think that the bias I bring to what I’m about to write is quite the opposite of what might be expected based upon that fact.

An op-ed by Nick Kristof in last Sunday’s New York Times has touched off a firestorm debate in the blogosphere and on Twitter regarding the role and relevance of tenure for those cloistered in the ivory tower of academia.  This column hit home for me for two reasons, both quite personal.

A significant portion of Kristof’s column digs into the fact that in political science in particular that those in academia have largely removed themselves from the public dialogue about politics.  Some want to argue that putting oneself into the public arena via Social Media is anathema to academic productivity (n.b.  a significant portion of my scholarly efforts right now are focused on demonstrating this is a myth).  The International Studies Association, an organization at which I presented research in one of my prior incarnations, recently proposed that editorial board members for their journals not be allowed to blog.  Perhaps the reactionary nature of what Kristof describes in his essay serves as a solid reminder to me why I left my graduate studies in political science and have looked back with no regret.  I simply could not see how my complicated econometric models were going to effect political change since they were incomprehensible to the Mothers marching in the Plaza de Mayo.  I was fortunate to work with some incredibly brilliant minds during my graduate career in political science, particularly having Mike Ward as my research mentor, but I do have a sense of frustration that most people have no knowledge of this community of individuals hard at work on issues of peace, human rights, and conflict resolution in international relations.  I know I could have had a good and intellectually challenging life in political science; I just happened to have an epiphany during my 2nd year of graduate school at CU that it wasn’t the life that I was supposed to have.

Then, there’s this issue of tenure in terms of how it relates to academic medicine.  The whole debate about tenure’s appropriateness and relevance is nothing new.  Kristof, however, quote Anne-Marie Slaughter that disciplines “have become more and more specialized and more and more quantitative, making them less and less accessible to the general public.”  I can think of no field for which that is more troubling than in medicine, particularly with the current push for patient and families to participate in shared decision making.  Participate in a little thought experiment with me here, if you will:

  • Criteria for academic promotion is scholarly activity on arcane things
  • Arcane things are, by definition, inaccessible and incomprehensible to the general public (and, for that matter, to people outside of a given specialty)
  • Patients and families are supposed to use what information to participate in “shared” decision making?

Summary:  Traditional scholarly activity in medicine is contradictory to what is being proposed as a best practice in social medicine.

While that may be an exaggeration, it sets up what we all really need to think about- why do we do what we do in terms of our scholarly work, and how can we make sure that those who most need to know about it (i.e. the patients, if we’re doing clinical and translational work) know what we’re learning?  Because if we’re in medicine, isn’t the focus supposed to be on the patient and what is best for them?