How My Greatest Accomplishment in Medicine Got Me My First Academic Job
Medicine is a strange career, in comparison to most, in that a doctor does not go on their first true job interview until they are nearly 30 years old. Prior to that, its really just trying to get into college, then trying to get into medical school, then trying to get into the right residency…. but never really interviewing for a job, per se. My first job interview was with Dr Kenneth Ward, then the chair of the University of Hawai’i department of obstetrics and gynecology. I was interviewing for an academic position, and the interview seemed to be going pretty well. We both liked technology, and were both Apple fans, so there was a fair bit to talk about other than just the job. Overall, we seemed to hit it off. Then he asked me a serious question. “So Nick, what was your greatest accomplishment in residency?” It was one of those canned questions that didn’t seem to have a right answer. I quickly thought of a bunch of good things I had done in residency, but none of them really seemed particularly impressive to me. But then I thought of my truly greatest accomplishment….. but it was so crazy I thought I might actually blow the job interview if I went for it. 50 milliseconds after that thought I launched into the story that sealed the deal.
And it went like this: “The truth is Dr Ward, I did a bunch of things in my residency that some people might feel was impressive. I made a number of good clinical calls that probably saved lives. I learned how to operate. A number of other things. But Dr Ward, any other human being having had my training and being in the same place at the same time would have done the same things….. so its hard for me to feel like those were really accomplishments. I was just doing my job….. But there was one thing that was truly special… but to understand this you have to understand breakfast at the Medical University of South Carolina.
On most of our services team breakfast was a big deal. After rounds we usually ate in the doctor’s lounge and it was a pretty good start to the day. But there was one problem that really bothered us…. and it was a sausage problem. You see, Dr Ward, the breakfast ladies made these really delicious sausage links on Tuesday and Thursday mornings. They were really the best links I’ve ever had. But for some reason, on Mondays, Wednesdays, and Fridays they would make these really ordinary Jimmy Dean style sausage patties that just were no good at all. We didn’t understand it, and we all preferred the links, but everyone just accepted it and waited for Tuesday and Thursday to roll around. But not me.
During my second year of residency, I started a campaign of comment cards to bring daily sausage links to the breakfast line. It started with a simple comment card suggesting that they serve links every day. A week passed and nothing changed. I tried another comment card, this time pointing out that the patties were inferior. Still no change. Week three, I tried a Haiku.
Delicious red links
Juicy, succulent, and good
Patties are so dry
Week seven, a rhyme
dry and red
Why not serve some links instead?
And so forth. By the end of my second year of residency I had submitted no fewer than fifty comment cards, each unique and pointing out a different reason why they should serve daily links. About mid year I spent a week taking a straw poll every morning among cafeteria diners on what they preferred, and sure enough it was at least 80-20 for the links. The results of that really stuffed the comment box. Towards the end of the year I became exasperated. All this work and still no links. I made a final push with a petition. I put it up on the cafeteria bulletin board, and in a week there was over a hundred signatures. And then suddenly it was gone. In my mailbox I found the petition, along with a note stating that I did not have permission to use the bulletin board to post my petition. I responded with a written letter pointing out my Constitutional right to petition (of which of course there is none in this context), and that if they will not allow me to use the bulletin board they must provide me with an alternate public location. And somehow, that did it. The links began to flow, every day of the week. I felt a sense of accomplishment I had never felt before. Not only would I enjoy my links every day, but everyone in the hospital could do so as well. And so Dr Ward, the truth is that if someone other than Nick Fogelson had been in my residency slot, all of those things I did for patients would have just been done by someone else. But if that other person had filled my slot, the hospital would still be serving patties three times a week. Instead, to this day, because of me, you can enjoy delicious links any day of the week.”
He responded with a laugh, a handshake, and a generous salary offer.