Letter From the Editor

Bruce D. Cheson, MD

Clinical Advances in Hematology & Oncology

September 2013, Volume 11, Issue 9


Many of you have played the game Mad Libs, in which certain words in a story are left blank and seen by only one of the players. That person asks the others for random words, such as adjectives or exclamations (we made sure to include plenty of expletives), to insert into the story. The result is silly and occasionally funny, especially to adolescents.

I was recently “volunteered” to be our new fellowship program director. Despite the incredible amount of time required, this position is appealing because it affords me the opportunity to make changes to the program that I would like to see. The most important part of carrying out my grand design is to attract the best and brightest from the pool of potential fellows, so I spent quite a few hours sorting through several hundred applications.

The curricula vitae were the first documents I perused. I saw that the education and ongoing training of the candidates were quite diverse. Volunteer activities ranged from being a dorm monitor or spending a few hours in a local soup kitchen, to spending months helping people in an underprivileged neighborhood or developing country. Anyone who had won a humanitarian award moved up on my list.

All of the applicants are required to submit a personal statement about what being a doctor means to them, and why they chose hematology-oncology. There was quite a bit of redundancy in their stories about the pivotal dying patient or family member that changed their life and made them realize that their passion was hematology-oncology. They agreed that much work remains in this specialty, and they want to be involved in helping the field progress. The applicants did their best to convey their enthusiasm, passion, compassion, and appreciation of research. They detailed the scientific and emotional journey that prepared them for any challenge, with a fellowship being the next essential step. It was hard to pick from among these sincere outpourings.

However, I found interpreting the letters of recommendation to be the most challenging. They reminded me of the introductory saying from Garrison Keillor’s radio show A Prairie Home Companion when he describes his fictitious hometown of Lake Wobegon, “where all the women are strong, all the men are good-looking, and all the children are above average.” Many were in the top 1% to 2% of graduates from their medical school, or from their country’s medical schools. All of the applicants were in the top 10% to 15% of their resident group, the “best in recent years,” or the “most outstanding” that the supervisor ever had the privilege of coming in contact with. They were the most thoughtful, compassionate, inquisitive, and diligent residents. One apparent slip-up was perfect for Mad Libs: the supervisor wrote that one resident was “the most ambiguous and en­thusiastic resident” he had ever seen. All of the candidates were the leader of their group and the favorite among their peers. They were all far above the quality of a resident and practicing at the level of an independent physician.

Folks, when writing recommendation letters for your young charges, say something less than perfect for the letter to be believable! Employ subtleties such as descriptors ranging from very good (which I consider not so good) to outstanding. And write about those whom you actually know. In several, the author had only worked with the candidate for a week or two, or had never worked with the resident but was writing from hearsay!

What really caught my attention was the “favorite activities.” I assume the list is required to demonstrate the well-rounded nature of the individual. Some were to be expected: travel, dance, cycling (sign that one up!), playing in a rock and roll band (after my own heart), cricket, hiking, family, cooking (generally ethnic). Others gave me reason to pause: “reading (both fiction and nonfiction),” “eating goat cheese,” “grinding coffee beans,” “sampling steak houses,” “playing with Legos,” and pursuing trivia. I think the winner for most oddball answer was the chap whose only pursuit was “a casual interest in philosophy.” I am curious to know what philosophy he embraced. Perhaps it was that of the writer and historian Will Durant, who wrote that “science gives us knowledge, but only philosophy can give us wisdom.” Another possibility is that of Ambrose Bierce, who defined philosophy in The Devil’s Dictionary as “a route of many roads leading from nowhere to nothing.” Or perhaps he was thinking of the Peanuts comic strip by Charles Schulz, in which Linus said: “There’s a difference between philosophy and a bumper sticker.” Casual interest? Whatever …

In the end, I chose more than 50 applicants to come for a visit, from which we hope to match the 4 best. I eagerly anticipate meeting a unique group of ambitious (not ambiguous) young doctors who will try to impress us, as we will them. After all, we have the opportunity to guide them through a critical phase of their career. So, if any of you candidates happen to be reading this epistle, know that I will ask everyone the same question: “What do you want to be said about you in 10 to 15 years?” The correct response? “That I made a difference.”

Until next month …

Bruce D. Cheson, MD