The Elements in Action

As an example, President Dwight Eisenhower was a young army officer during World War I, after which the U.S. military shrank dramatically in size, promotions were scarce, and careers stagnant. He served in the U.S. Army with distinction for decades, earning accolades from his superior officers but languishing at lower ranks for extended periods with little hope of promotion. Then, World War II changed everything, as the U.S. Army experienced its largest-ever expansion from fewer than 200,000 soldiers in 1939 to more than 8 million soldiers in 1945. This 40-fold growth exponentially increased the need for senior officers and provided previously stagnant but able and hard-working officers the opportunities they needed to achieve prominence on the global stage. Eisenhower, one of these men, served as Supreme Allied Commander in Europe, where he worked closely with the leading men of his age and was ultimately hailed as the man who defeated Hitler. He returned home such a widely acclaimed national hero and with such a rich network of affluent connections that it seemed to many a foregone conclusion he would become president. He is a prime example whose legacy as a person of history rather than a capable but forgotten soldier was made possible by unique opportunity.

How Does This Apply to Us?

FROM TOP: Dwight Eisenhower, Jackie Joyner-Kersee, Jesse Owens, and Marie Curie.

As emergency physicians, our academic and professional achievements are evidence of our ability. In large measure, we are intelligent, innovative, and emotionally intelligent. We should take satisfaction in the gifts of ability we have been given. If we seek rarified heights of professional accomplishment, we need to focus further to identify our unique personal abilities toward which to deploy still more effort to enhance our chances of exceptional achievement.

Emergency physicians are also no strangers to focused and sustained effort. Logging 11 years or more of post–high school education and enduring workweeks so intense that they are capped at 80 hours, we epitomize outsized effort applied to maximizing our inherent abilities. Emergency medicine is still a large field, so historic achievement requires further focus. Ultrasound, toxicology, cardiovascular disease, etc. offer paths to focused clinical excellence. Many of us possess talents in education, health policy, politics, executive management, etc. If we seek to truly excel, we must focus further, identify our differentiating abilities, and refine them through hard and sustained effort.

Even in possession of the above, we still require that essential third element: opportunity.