Editorial Perspective
The Slingshot JOSEPH PAVIGLIANITI, MD have been thinking about my legacy a lot lately. I’m not really sure why, but over this last year or two, I find myself reflecting a lot on what my legacy will be to my children and to my community, and perhaps, presumptuously, to the world. How will I be remembered? What stories will my kids tell about me to their kids? When I die, will anyone care? Did I make a difference? The idea of “leaving behind a good legacy” strikes me as similar to the idea of funerals and wakes. Legacies and funerals are constructs “for the living” and exist for those left behind, as a way to comfort and begin the process of closure. When you’re dead, you really don’t care what kind of casket you are in or what they say about you. But those you leave behind do. Similarly, when I’m pushing up daisies, I won’t care about the legacy I leave behind. But while I’m alive, the concept of building up a strong legacy reassures me that when my time comes, I will die “at peace.” Whilst some of us might want to “go out with a bang” while doing something heroic, I presume that most of us want to die peacefully, with few regrets and many of our goals accomplished. We hope for the cinematic matriarchal death scene, surrounded by our families as we slowly slip into oblivion, knowing that our loved ones are cared for, and that we lived the life that we were intended to live and put
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to use all the gifts and talents we were given. We ran a good race and crossed the finish line before the finish line came to us. About 12 years ago, while in my mid-40’s, I started reading The Last Lecture by Randy Pausch, a CMU computer science professor with terminal pancreatic cancer. He and his wife had delivered their third child just months earlier when he got the news of his cancer diagnosis; after some quick research on the dismal prognosis of pancreatic cancer, his priorities instantly changed. He needed to make sure his young family was provided for after he was gone. After that, he wanted a chance to be able to talk to his kids “from beyond the grave” and give them some fatherly advice when they were old enough to need it and understand it. But life in your mid-40’s is busy: young kids, homework, chauffeuring to sports and school events, medical practice in full swing, “on call” responsibilities that take up what little free time you have, patients that need help after hours or late in the clinic day such that you miss (or are really late to) all those great sports contests, school band concerts, birthdays, etc. The list is endless. You will note I left “spending time with one’s spouse” off the list, because, sadly, spouses are often left off the list, or at least shoved really far down
it. I could not be a successful physician and father without my wife filling in the many places where I fall short. The career we have all chosen takes us away from our families far more than the average parent. Our kids and our spouses get the short end of our time-stick. It’s tough being a spouse to a physician. In the old days, parents wanted their kids “to marry a doctor; I’m not sure I would give that advice to my own children. While I am generally happy with my choice to become a physician, by far the smartest and most important decision I ever made was not to become a physician, but rather to wait patiently until I found the right person to spend my life with…and to build my legacy with. I won the wife lottery. Anyway, I only got a few chapters into the Pausch book before getting distracted with “life.” I got sidetracked and forgot about it. For years. But, it’s a decade later now and I’m clearly on the downward descent of the arc of my life. Hopefully it’s a long, graceful arc, but one never really knows, do we? So, now in my mid-50’s, I went on a mad hunt, found the Pausch book and started it again. And it’s got me thinking. If I were to die before my kids were all “fully cooked,” how can I reach out from beyond the grave and have a presence with my kids and dispense fatherly advice posthumously? www.acms.org
