On Promotion: A Quiet Confession

Recently, I was promoted to a higher academic rank at my institution. Word traveled, as word does, and congratulations arrived from many directions: warm, generous, sincere. I could feel the enthusiasm in the texts and voices of colleagues and friends who saw this as a milestone in my career. And it is one. I do not dispute that.

But something in me has needed to be said aloud, and I have hesitated to say it.

My first instinct was to keep the news quiet. There was a reluctance I couldn't quite name. When I examined it, I found something uncomfortable underneath: staying silent felt like a way of avoiding honesty with myself. And the honesty is this. The promotion does not feel as significant to me as it appears to feel to everyone else.

I want to be careful here, because this admission risks sounding ungrateful, and gratitude is precisely what I owe. Many people put real effort into this process: the staff in my department who assembled the dossier, the colleagues who wrote letters on my behalf, the committee members who read the application carefully and rendered their judgment. To say the promotion doesn't matter to me would seem to disregard their work, and that is the last thing I intend. Their effort was genuine, and I received it as a gift. My unease is not with them. It is with what promotion came to mean in my own life.

When I began my journey, promotion was not among my original aspirations. As a medical student, and then as a resident, I never imagined I would care about academic rank. My goals were simpler and, I believed, truer. First, to take excellent care of patients. Second, to do research: to pursue questions that had not yet been answered and to carry the answers back to the bedside, toward better care and new treatments for patients, especially children, who still need them. Third, to teach: to participate in the education of students and trainees, so that the progress would continue.

But I learned quickly that these goals are entangled with promotion in ways I hadn't anticipated. To sustain a research program, to hold a teaching role, even to keep caring for patients at an academic institution, all of it presumes that you advance. If you do not, eventually you must leave. And so, reasonably enough, I accepted the path, with early enthusiasm and some early success.

What I did not foresee was how the pursuit would change me. Slowly, almost imperceptibly, promotion moved from the periphery of my attention toward its center. I was still doing the clinical work, still caring well for my patients, but the weight of promotion grew heavier with each year, and it pulled focus from the very things it was meant to serve: the patients, the research, the teaching.

The image that comes to mind is a long race with periodic cutoffs, like a triathlon. You cannot simply run at the pace that is right for you; you must run fast enough not to be pulled from the course. Those are the rules of the triathlon, and, similarly, the rules of academic medicine, and I do not begrudge the institution its standards. Perhaps I am slower, more easily distracted than others. Perhaps my academic output has not always met the bar that others set, and I recognize that plainly, without excuse. 

But here is what I have come to understand about myself: the race I care about is not the five-year race, or the ten-year race, to the next rank. My career, or more accurately my journey, began the moment I recognized that I wanted to practice medicine to help people, and it will end only when I die. And if one believes, as I am inclined to, in lives beyond this one, then perhaps not even then. Measured against that horizon, a promotion is a mile marker, not a destination. It tells me where I am on the course. It does not tell me why I am running. And to fix my gaze on the mile marker is to risk mistaking the marker for the thing it measures, losing sight of the guiding star, the Purpose with a capital P.

So this is my confession, offered with my utmost humility. I am grateful, truly, to everyone who helped me to this point, and I honor the meaning that promotion holds for others, because for many of my colleagues it represents years of sacrifice and hard-won recognition, and that deserves celebration. I celebrate it with them and for them. But for myself, I have marked this milestone and moved on. I want to keep my attention where it belongs: on the child on the operating table, the question in the laboratory, the trainee at my side. The direction I run is not set by those mile markers, but by the true North Star I have rediscovered. Those were the reasons I began. They are the reasons I will continue.

The lesson I take from this is perhaps very simple: pace yourself for the longer race, and enjoy the journey, so that when the mile markers come, and they will come, and pass, you can have a good time and still remember where you are going.