By Eric P. Thorson, MD

One of my favorite quotations is among the many attributed to the famous American author Mark Twain. I first ran across it at the bottom of a one-page paper memorandum (in the days before email) whose contents were otherwise quite forgettable. I liked the nautical imagery and kept it on my desk. It survived my periodic attempts at cleaning the desk for decades. 

“Twenty years from now you will be more disappointed by the things you didn’t do than by the ones you did do.  So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.”

 As the years rolled by, I would sometimes look at that memorandum – then usually get back to what needed to be done. Most hand surgeons realize the large impact they have on their patients’ lives and work very hard to be correct in everything they do. While admirable and necessary, this drive can also lead to a narrowness of thought and loss of the bigger picture. Time, as well as financial and competitive practice pressures, may further drive behaviors which tend to make our thinking conform to standards not necessarily beneficial to our patients or to our profession. This group drift phenomenon is nicely described in Paul Brand’s observations while sailboat racing.  Many older ASSH members are familiar with this lesson. (Brand PW. The pursuit of happiness. J Hand Surg 1992; 17A: 593-7.) 

Because not all patients are alike, and not all problems have good solutions, it is important that the complete hand surgeon takes time to cultivate a little individuality; to find their own way to explore and discover, and maybe become a more insightful and independent-thinking physician. Patients usually appreciate this. For me, travel with family gave a wider perspective on what mattered, in spite of the difficulties and disruptions this caused in the daily grind of work in a community practice. Non-practice related professional efforts like hand society committee work, Orthopedics Overseas, or giving a talk at the local community college help confer a confidence that it’s okay to be a little independent or unconventional. Looking back, these “tangential activities” helped me grow and were among my most satisfying medicine-related activities. Mark Twain had good insight.