What a Young Billy Joel Fan Can Teach Us

I was the tender age of 12 when Billy Joel released his groundbreaking album, 52nd Street, in 1978. His songs were all over the radio, and I fell in love with them. When his tour stopover in Wichita, Kansas was announced, I begged my parents to go. After some inter-parental discussion and to my great disappointment, it was determined that I was too young to attend the show. As consolation, Mom took me to Musicland in Towne East Square and picked up the 52nd Street LP for me to take home and enjoy. And boy did I enjoy it. I played both sides over and over, memorizing every word. “Zanzibar” remains one of my favorite songs of all time. Imagine my surprise and delight when, upon finally seeing a live Billy Joel concert several years ago here in Seattle, he performed that obscure but wonderful piece from 52nd Street; it felt like he played it just for me.

(In the unlikely event that you’re interested, I eventually wore my parents down, and my very first rock concert ended up being Kiss in 1979, a year after 52nd Street was released.)

I am but one of many millions who have loved Billy Joel’s songs over the years. Recently, during a Q and A with Joel at Vanderbilt University, a freshman named Michael Pollack stood up and asked if he would be willing to be accompanied by him on piano on “New York State of Mind,” his favorite song. Joel granted him his wish, much to everyone’s delight, and the musical result was . . . well . . . incredible. Inspiring. Please click on the video above to witness the performance.

There’s a lesson or two to be learned from this brief event, one which I’m sure Michael will never forget. This world is getting smaller, but the number of people inhabiting it is getting bigger. How are today’s young people to survive and succeed with so much competition surrounding them? It’s no longer sufficient to be good at what you do. You have to have guts now. Billy Joel, in his typical east coast nonchalance, said of Michael, “guy’s got chops!” No disagreement there; he killed it on the piano, as you can see. But another quality Michael possesses is just as crucial, if not more so: guy’s got cajónes too. Big ones.

The favor Michael asked of Joel was asked for honestly and audaciously. No one outside his friends, family, and teachers would know who Michael is today if it weren’t for that moment of boldness and risk. It paid off.

We are at a societal turning point here in the United States. Health care is in a major crisis. Regulations, ever-declining reimbursements, minimal autonomy, increasing overhead and malpractice premium costs, mounting paperwork and administrative hassles: it’s becoming more and more difficult for doctors to find success and happiness in their work. This isn’t a whine or a call for sympathy; it’s just factual. My concern is, in a time in which doctors are retiring early or just plain quitting, who of our young citizens will choose medicine as a career in the future? Why should they go through the hassle and put in all that money, time and effort for so little in return?

I’ve been asked recently by high school and college students if I would recommend medicine as a career. My answer was that it really depended on who they are, based on honest self-assessment. There’s a definite analogy I see between the qualities of a successful and happy future doctor and those of Michael Pollack, the Vanderbilt freshman pianist:

1. You have to have passion. You have to really want it, and for the right reasons.

2. You have to be good.

3. You have to have the audacity to work aggressively to get what you need or want, because in today’s way of the world it’s no longer given to you or made easy.

Seems to me that a young man or woman possessing these three elements should be able to weather the current health care storm and carve out a satisfying, fulfilling career in medicine. If any of the three are missing, however, the happiness factor will plummet, I can promise you. A missing link or two may be why there is so much unhappiness and dissatisfaction among doctors right now.

I want people to go into medicine in part, admittedly, for selfish reasons. I want a quality physician to be willing to care for me when I am old. Doesn’t everybody?

So to those kids and teens considering becoming a doctor: do it if you really want it. If you really want it, and if you know it, and if you know what you’re getting into, then go for it. And go for it hard. Not obnoxiously or unethically, but boldly. It takes audacity now to make it in this world. If you ever want a reminder of what that quality looks and sounds like, click on the video again.

Have a great weekend, everyone!

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A St. Patrick’s Day Anecdote

 

Long ago during my training years, a man in his early sixties—I’ll call him Karl—was admitted to our hospital service one day in mid-March. Karl had metastatic cancer, and he was dying. We on the in-service team liked him very much, remarking quietly to each other how it so often seemed to be the good ones that die early of such tragedies. Despite his terrible prognosis and physical discomfort he was pleasant–jovial, even–during morning rounds, putting everyone at ease with his polite disposition.

One day we walked into his hospital room, and he was having a tough morning, though not for physical reasons. He was really down, uncharacteristically so. We asked him what was troubling him. A little embarrassed at first, he shared that it was St. Patrick’s Day, and true to his Irish roots he normally celebrated that day with a glass (or two) of green beer. Doing so was a custom of his and his family’s for decades. He told us how unfortunate it was that he wouldn’t be able to celebrate this way this time ‘round.

Upon examining him and talking with him further, we took our leave and somberly continued morning rounds. Afterwards I stood at the nurses’ counter with my chief resident. I was post-call and yearning for sleep, so I wasn’t paying much attention to what he was doing; I was hanging around until his exit off the floor, which was tacit permission for me to go home and go to bed. He made a couple brief phone calls and wrote something in a patient chart. He slammed the chart shut, startling me, and grinning widely he proclaimed, “That oughta do it!” And he walked off, swinging his stethoscope in his hand as he disappeared down the hall.

I looked down: it was Karl’s chart. I couldn’t help it, of course. I opened it, flipped to the “orders” section, and read the following in my chief resident’s barely legible scribble:

“Administer 1 glass beer p.o. x 1. Apply green food color prior to ingestion.”

I smiled as I left the hospital that morning.

After awakening from my post-call nap I called the floor and spoke with Karl’s nurse. He had enjoyed his green ale. Several days later he went to hospice a happier man.

That was a couple decades ago. I hear that beer is still available in some hospitals. But I wonder how difficult it would be for a dying person to get it these days. The process of health care is so burdened now with endless complexities—regulations, statutes, administrations, commissions, regulations, third party payers, boards, committees, and did I mention regulations?—it seems hard to believe that underneath all of that still exists the original idea that I went into medicine for in the first place: to actually care for people, to make what is miserable less miserable, to heal, to help make life a little better, maybe lengthen it too. All this sounds so quaint and clichéic now, things one might say in a medical school interview. But isn’t it still true, what we’re all still supposed to be doing in health care? If so, does the administration of health care now really have to be such a struggle, such a fight all the damn time?

To some of those non-clinicians who have their hands in the business of health care, I would ask what they would do if charged directly with the task of making a person’s life better. What rules that they themselves created would they try to bend to grant a dying man a green beer? Or would they? A green beer would be difficult to pre-authorize.

As my life continues on, I am increasingly grateful for what I have, who I have it with, and what I am allowed to do every day for work. I think of Karl every St. Patrick’s Day. To my readers, if you choose to celebrate a little tonight, I’d appreciate your lifting one up to Karl and cheering the greatness of life. We’re lucky to have each day we have.

Happy St. Patrick’s Day, and Happy Selection Sunday!  Lá Fhéile Pádraig Sona Daoibh!