Meditations and Reflections
1. Patients Were My Greatest Teachers
Every patient has a story. Before every diagnosis is a person who hopes to be understood. Medicine begins by listening—not interrupting.
Over the years I learned that trust is built through careful attention, honest conversation, and genuine compassion. Technical skill matters, but patients remember whether their physician truly cared.
I think that, the greatest compliment a patient can give is not, “You cured me.” It is, “You understood me.”
2. Surgical Judgment
The best operation is the one you don’t do; the second best is the one you do the least on.
When surgery is necessary, do only what is needed—and preserve everything that nature has already perfected.
Good surgeons learn technique. Experienced surgeons learn restraint.
The highest goal is not simply technical success but preserving or restoring breathing function for decades to come.
3. Preserve Physiology
For much of my career rhinology emphasized removing tissue.
Increasingly we understand that preserving physiology is more important than enlarging anatomy.
The nose is not simply a passage for air to the lungs.
It is a living sensory organ.
Future generations may look back on this transition as one of the great turning points in rhinologic surgical history.
Whenever possible: Preserve function. Restore function. Respect physiology.
4. Mentors and Lifelong Learning
No physician succeeds alone. I owe an enduring debt to remarkable teachers, colleagues, nurses, residents, fellows, and patients.
- Maurice Cottle, MD Chicago taught that physiology especially breathing function comes before appearance.
- Vernon Gray, MD Los Angeles demonstrated that gentle surgery is often the best surgery.
- Fausto López-Infante, MD Mexico City showed that meticulous technique and long-term follow-up are inseparable.
Every student teaches the teacher. Curiosity is the beginning of wisdom. The day we stop learning is the day we stop growing.
5. The Future of Rhinology
Medicine continually changes. Recent discoveries in neuroscience have transformed our understanding of breathing, sensory perception, and the Empty Nose Syndrome. The future may include sensory nerve regeneration, tissue engineering, neuromodulation and treatments we cannot yet imagine.
Today’s certainty often becomes tomorrow’s question. Medicine, according Sir Karl Popper, the 20th century philosopher of science, is always at a point of temporary conclusions or at an “approximate temporary truth” which can change tomorrow, based on new evidence which produces another “approximate temporary truth.”
Progress begins when we are willing to question our assumptions about the current state of the most recent “approximate temporary truth.”
6. What Matters Most: “Final Thoughts”
Gazing back, publications, lectures, and awards have been gratifying, but they are not the true measure of a career. The lasting legacy of a physician’s career is found in patients whose lives were improved, in students who became wiser physicians and the ideas that help others long after we are gone.
Teaching has been one of my life’s greatest privileges. Over the years, I discovered that the teacher often learns more than the student.
After more than six decades in medicine, I do not feel entitled. I feel grateful. Every patient who trusted me, every student who challenged me, every colleague who shared an idea, and every scientific question that remains unanswered has been a privilege. Medicine has never simply been my profession. It has been a calling and one of life’s greatest gifts. These gifts have been health, a cherished wife-life partner, family, friends, colleagues, and the privilege of a career devoted to service in medicine.
In the end, contribution is what matters most. Everything else either follows, or it doesn’t.
Do the right thing. Give your best every day. Contribute whenever you can. You cannot always control the outcome, but you can always control your effort, your integrity and your character. Finally, you understand that medicine itself is about people, gratitude, and contribution.
If these pages help explain a difficult clinical issue, encourage a student to ask questions, prevent an unnecessary surgery, or improve the life of one patient, then this work has been worthwhile.
