Friday Reflection 18: An Homage to Mentors

With a little bit of mythology thrown in

AC, a college freshman, had just received the results of his first organic chemistry exam and the news was not good. He sat in the lecture hall a bit shell-shocked. This young man was going to need some help.

The fourth year of medical school is the greatest wasted opportunity in all of education. It is a transitional year for students. At the start of the year, students are accustomed to teachers telling them what is important and then teaching them. By the end of the year students must be able to figure out what they need to know and how best to learn it. The fourth-year curriculum should help students adapt to this change. Generally, it does not.

Months ago, I wrote a reflection about how eavesdropping is an important resource for lifelong learning. It was silly to start with that since continuing medical education comes mostly from reading journals, studying patients’ diseases, observing how people react to their doctors and their illnesses, and questioning what we don’t understand.[i]

We also learn from mentors.

As a medical trainee moves from formal education to practice-based learning, mentors become critical. An ideal mentor is an advisor who shares knowledge and wisdom. She should be generous, providing opportunities and introducing the mentee to new and advantageous networks. Over time, she may even become a colleague and friend.

Because every article ever written about mentoring references the etymology of the word mentor, I’ll do the same. When Odysseus headed off from Ithaca to a brief, historically insignificant skirmish in Troy, he left his son Telemachus in the care of Mentor. Pretty much every article fails to note that it is really Athena (Minerva in Roman parlance), in the guise of Mentor, who does the mentoring.[ii] This oversight may be rooted in the sorry state of classics training, sexism, or in mentors objecting to the phrase, “He’s my Athena.”

There are as many types of mentors as there are mentees. One article describes archetypal mentors as the traditional mentor, the coach, the sponsor, and the connector. Of course, actual mentors don’t fit neatly into any one category.

This reflection is an homage to a few of my mentors. People who supplied tailwinds, shaped my career and supported me in different ways at different times. My hope is that in describing them, you might reflect on yours.[iii]

Claude Wintner taught me the importance of organization, dedication, and focus. He also provided a model of a gifted educator. He was a teacher who evolved into a mentor.

Professor Wintner (I still have trouble calling him Claude) taught my organic chemistry class during the second semester of my freshman year at Haverford College. Half the class, including me, failed our first exam in this class. If I remember correctly, Claude was a bit miffed after grading the exams. He stood in front of the class and made it clear that he thought our performance reflected not on his teaching but on our study skills. He told us that he had been teaching this class for 20 years, continuously refining his instruction. Same material, same professor, better teaching, the problem was us. For those who didn’t just leave the class when they saw their scores[iv], Claude delivered an hour-long lecture on time management and study skills.

I have never attended a more important lecture. I am not sure where I’d be without it. I followed the time management recommendations for the rest of college – irritating my friends as I calculated my necessary hours of sleep. I slavishly abided by the study techniques: “copy your notes, you learn through your fingers.” Claude’s lectures were perfectly crafted. They were performance art for a highly select audience. His dedication to his teaching is manifest in a monograph that he published to accompany his lectures.[v]

With time, Claude became a trusted advisor (because he remained a bit larger than life, I could never think of him as a friend). I learned chemistry from him but he also taught me about the impact of the ’87 stock market crash and the causes of the Shuttle Challenger disaster.

My most vivid memory of his mentoring is from a time that I met with him to discuss dropping a class he was teaching. I was worried about how he would react – the class covered a topic he loved and there were only three students enrolled. We sat in his office, where he asked about my past, my goals, and my interest in Italian Renaissance art, the subject of the class I wished to take instead of his. He was genuinely interested in how I was piecing together my curriculum.

He chuckled when I said I was worried about his reaction to me dropping the class and practically guffawed when I said I was concerned that my absence might negatively affect the class. “Adam, your education is yours. I am only here to help you make the most of it.” 

Olaf Andersen nurtured my interest in science and guided my entry into medicine.

I worked in Olaf’s biophysics lab after my freshman and junior years of college. This job was a revelation, doing laboratory science not from a cookbook lab manual but designing your own experiments to answer questions that you (or your advisor) had dreamed up. Though I knew basically nothing, Olaf treated me like a graduate student. Responding to his expectations, I learned the obsessive attention to detail necessary for successful lab work. I read constantly; it took me many times longer to prepare for journal clubs than those more experienced (and more schooled) than me.

Being incorporated into the lab didn’t only mean work. It meant Friday afternoon happy hours with the lab staff and an invitation to his home for Christmas.

When it came to advising, Olaf was exceedingly generous. During the writing of my first scientific paper, he reviewed version after version and did the heavy mathematics lifting that was beyond me. He also accepted me for who I was. He guided me toward a major in chemistry, a decision that was certainly the correct one. He made a pitch for me applying to MD/PhD programs but was unperturbed when I explained that I could not imagine doing a basic science PhD.

Thinking about Olaf also reminds me of my privilege. I landed a spot in his lab because the daughter of a close friend of my father had worked in his lab. It’s not every college freshman who gets to work with the scientist who runs the MD/PhD program at a top medical school. I have no doubt that his recommendations helped get me into the medical school I attended.

Carol Bates showed me what it means to be a specialist in general medicine and a clinician educator.

At the beginning of residency, I was planning to specialize in pulmonary/critical care. I ended up a generalist because of mentors. Carol was foremost among these. She led the residency’s “primary care track.” Our training gave me an image of the internist I’ve been striving to be ever since: a generalist committed to patient care, up to date on the medical literature, capable of diagnosing and caring for the most complex patients and, when necessary, comfortable overruling consultants. The training that Carol organized had us rotating outside the ivory tower: Healthcare for the Homeless and Fenway Health, with doctors of all specialties doing home-care, and seeing patients in nursing homes. I spent weeks with orthopedists, urologists, and dermatologists.

Carol was also by my side when I interviewed for jobs halfway across the country. She provided advice about salary, contracts and future opportunities. When I signed on for a job, she warned me about one potential minefields - a warning that turned out to be remarkably prescient.

Halina Brukner mentored me during my career at the University of Chicago.

I refer to Halina as my academic fairy godmother. Mentoring junior faculty is a wholly different task than mentoring students and trainees. Your mentee is balancing a life with their professional world. Halina was a sponsor and a connector, always thinking about me for roles that made sense for my strengths and my goals. All the while, she introduced me to people with whom she thought I’d work well. She never objected when I said no — or not now — to an offer.

Mostly, we think of mentorship occurring early in our careers. This is true. As you progresses through your career you might still have a boss or sponsor but there is less formal mentoring. This certainly does not mean there is nothing left to learn, it is just that the mentoring comes from colleagues, a mentorship of equals. These are collaborations that make everybody better and become some of the longest lasting mentorship relationships.

I began working with Diane Altkorn and Scott Stern soon after I arrived at The University of Chicago. We have worked together on lectures, articles, courses, textbooks, mentoring, podcasts, and of course patient care. My relationship with them has improved my diagnostic reasoning, doctoring, teaching, and (in the case of Diane) my writing. I hope they might say something similar about working with me.

Now, because I am a cynical New Yorker at heart, I have to note that we all come upon people in our lives and careers who could have mentored us but failed to. There is a terrific article that defines different types of mentorship malpractice: the hijacker; the exploiter; the possessor; the bottleneck; the country clubber; the world traveler. For me, potential-but-failed mentors did not commit malpractice but were selfish. They offered opportunities not because they were right for me but because they needed a position filled. These people never took the time to figure out who I was or what I would be good at.

We all need mentors/Athenas for teaching, guidance, and support. Most of us need many: different ones at different stages of our lives and careers. We should reflect on the ones who were successful, thank them — and pay it forward.

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[i] Trust me, the order of the reflections is completely unplanned.

[ii] For what it’s worth, here is documentation of the first mentoring. As my ancient Greek is a bit rusty, I take this translation of the Odyssey from The Internet Classics Archive:

As (Telemachus) thus prayed, Minerva came close up to him in the likeness and with the voice of Mentor. "Telemachus," said she, "if you are made of the same stuff as your father, you will be neither fool nor coward henceforward, for Ulysses never broke his word nor left his work half done. If, then, you take after him, your voyage will not be fruitless, but unless you have the blood of Ulysses and of Penelope in your veins I see no likelihood of your succeeding. Sons are seldom as good men as their fathers; they are generally worse, not better; still, as you are not going to be either fool or coward henceforward and are not entirely without some share of your father's wise discernment, I look with hope upon your undertaking. But mind you never make common cause with any of those foolish suitors, for they have neither sense nor virtue, and give no thought to death and to the doom that will shortly fall on one and all of them, so that they shall perish on the same day. As for your voyage, it shall not be long delayed; your father was such an old friend of mine that I will find you a ship and will come with you myself. Now, however, return home, and go about among the suitors; begin getting provisions ready for your voyage; see everything well stowed, the wine in jars, and the barley meal, which is the staff of life, in leather bags, while I go round the town and beat up volunteers at once. There are many ships in Ithaca both old and new; I will run my eye over them for you and will choose the best; we will get her ready and will put out to sea without delay."

[iii] I’d love to hear about your mentors in the comments.

[iv] I am not exaggerating when I say that a dozen or so people just walked out after they saw their scores, never to return. A student in front of me said, as he packed his bag, “Well, there goes my grandmother’s dream of me becoming a doctor.”

[v] In retrospect, it is interesting that Claude let us drop our lowest exam for the course. I, like all of my classmates, dropped this first one. I scored in the high 90’s on the rest of the exams. I wonder if this was all part of his teaching technique.