This blog post is taken from my comments to the incoming class of residents of the St Mary’s Family Medicine Residency in Grand Junction, CO. The setting was the Devil’s Kitchen trail in the Colorado National Monument during our annual orientation hike.
Long ago, there was a traveler who came upon three men working with stone. Curious as to their labors, the traveler approached the first worker and asked, “What are you doing with these stones?” Without halting, the worker responded, “I am a stonecutter and I am cutting stones.”
Not satisfied with this answer, the traveler approached the second and asked, “What are you doing with these stones?” The worker paused for a moment, wiped his brow, met the traveler’s eyes, and stated “I am a stonecutter and I am making money to support my family.”
Having two different answers to the same question, the traveler made his way to the third and asked, “What are you doing with these stones?” The worker thought, laid the chisel on the stone, engaged the traveler with his smile, and declared, “I am a stonecutter and I am building a cathedral that will bless my family, friends, and townsfolk for generations.”
This oft-told tale seems particularly poignant in this setting. We talk today in a natural formation that belies both its name and its natural provenance. Rather than a devilish pile of random rocks, to me it is the closest structure Grand Junction has to a timeless cathedral.
Within this serene space, we reflect on the beginning of your vocation as a family physician. Over the next three years, your training will offer experiences that could easily inspire the perspectives of each of the stone cutters. First, there will be times when your duties feel like laborious, mindless stonecutting. Second, as this is the first time you’ve been employed as a doctor, you are now straddling the worlds of the learner and the paid staff physician. And third, each of you brings with you a vision of why you chose this noble, yet demanding profession.
While each of these perspectives is reasonable and grounded in the truth, I assert that your time in residency will be more fruitful, meaningful, and agreeably fast-paced if you approach it as the third stonecutter. He benefits from vision, passion, and ownership of his craft. To build your cathedral, you will need to hold-on to all three.
Fortunately, there exists a detailed blueprint for your cathedral that will guide you through this process. Revisiting the blueprint will lift your eyes to the spires and away from the inane hassles. You designed the plans yourself, about one year ago as you were preparing to apply for residency programs. Each of you wrote a personal statement in which you described in vibrant terms why you had entered medicine and why family medicine was the ideal specialty for you. For some it was a passion for enduring “cradle to grave” human interaction. For others, it was the intellectual challenge of a comprehensivist practice. And for others, it was a mission to bless the under-served of rural America and third-world countries.
With time (predictably during the winter of your second year), this blueprint might begin to seem corny or naïve to you. The challenges of full-spectrum training and the comments of others in the medical field might obscure this vision. Guard against this disillusionment. Based on my experience with previous classes, I predict that the closer you remain to your initial vision, the more meaning and delight you will derive from residency and your career.
Like stonecutting, family medicine is a worthy craft. Unlike stonecutting, it will also afford a very comfortable life for you and your loved ones. But, the noblest reason to engage fully in your training is to build the cathedral that you initially envisioned. I look forward to witnessing the realization of your plans and to offering a scaffold to your labors.
This blog post was originally posted on the CFHA Blog on July 19, 2012.