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
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
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.
Randall Reitz , PhD, LMFT is the Director of Behavioral Sciences at the St Mary's Family Medicine Residency in Grand Junction, CO. In addition to training residents he also directs a fellowship in Medical Family Therapy. His scholarly pursuits include medical family therapy, professional development, healthcare ethics, and integrated primary care.