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Embrace the dreaded ‘F word:’ Dr. Toby Cosgrove (Opinion)

May 27, 2018

Embrace the dreaded ‘F word:’ Dr. Toby Cosgrove (Opinion)

CLEVELAND, Ohio - I’m an unlikely candidate to give a college commencement speech.

You see, I myself did not have a distinguished college career. Diligent study produced a collection of Cs. No honor societies or distinguished offices graced my curriculum vitae. Twelve of 13 medical schools to which I applied rejected me. During my residency at Massachusetts General Hospital, I was informed that I was the least talented individual in my residency group and was advised not to go into cardiac surgery.

So in delivering this keynote address to the 2018 graduating class of Case Western Reserve University, I have chosen to discuss something people rarely talk about. The dreaded F word. Failure.

Failure is a great teacher. As a cardiac surgeon, three or four times each day, I would stop a patient’s heart from beating for one or two hours, perform some type of surgical intervention, and attempt to restart the heart. In each case, there was a moment of tension while I waited to see if the heart would start beating.

Were all of my decisions correct? Were all sutures accurately placed? Did I operate rapidly enough?  In 99 percent of the cases, the heart would start pumping; the tension would be relieved, and we would move on.

In my more than 20,000 heart operations, it is difficult to remember the successful outcomes. It is the 1 percent of patients who do not survive that are remembered in vivid and agonizing detail.

From this 1 percent, most of my lessons were learned. You learn vastly more from your mistakes than you do from studying the medical literature.

Failure is an opportunity to learn. We may learn that our present strategy won’t work; we may learn that our goal was not worthy; we may learn that we quit too soon.

Failure will teach you, if you let it. To derive the maximum benefit from failure, it must be analyzed retrospectively. In academic medical centers throughout the United States, deaths and complications are discussed among peer groups. This open discussion is a long and honored tradition in medicine which forces us to analyze our failures. It provides an opportunity to admit defeat, to learn, and to advance.

Our instinct is to hide our failures. Our responsibility is to acknowledge and learn from our mistakes so that we may improve our performance.

It should be clear that life is not a sprint, but a marathon. We must recover from defeats and failures, afflicted but not crushed ... humbled but not despairing ... knocked down but not knocked out. The only true failure comes when we fail to rise and try again.

My point is that failure is temporary; it is a source of experience and most importantly, failure is an event in each person’s life, but it is not the person.

At the age of eight, I came across photographs of a surgeon in the operating room who was a respected family friend. The dramatic pictures of this individual in cap and mask became engraved in my imagination and I envisioned myself in the same situation. My dream was born.

What we dream is what we think. What we think is what we become. It is important that your dreams be lofty. Only those who dare to fail greatly can ever achieve greatly.

My college education actually began before enrollment. My father took me to visit his long-time friend and revered history professor, Charlie Keller.  Naturally, as a high school junior, the discussion came around to how to gain college admission.

We were both startled when Professor Keller said, “Don’t tell me his I.Q. What is his G.Q.?”

He enlightened us.  “Tell me about his Guts Quotient.”

He went on to explain that the SATs, which he helped originate, were not the only predictor of college performance.

Keller believed that character and determination are, in large measure, responsible for success.  By now, it must be clear to you that I have failed ... and you will, too. It is how you handle your failures that will define and determine your success.

Dream a grand dream; relentlessly pursue your dream; and do not fear failure.   When failure comes your way, which it surely will, use it as an opportunity for growth.

Dr. Toby Cosgrove is executive advisor, and former president and CEO of Cleveland Clinic.

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