The letter I never asked for

He wrote that I was behind my peers. Then he called Mayo.

I never asked my attending for a letter of recommendation. He had already written that I was behind my peers in basic surgical skills and knot tying.

Second year of residency. Pediatric orthopedics. Worst evaluation I got in five years. It made me furious. I tied knots until my fingers knew them in the dark. Practiced when nobody was watching. Not to prove him wrong. To make sure he was never right again.

Then I went and built the case for myself.

Manuscripts written after call at a program with almost no research infrastructure. Studies nobody assigned me. A keynote speaker I turned into two book chapters. Two trips to Rothman on my own vacation days to shadow in the OR, long before I was an applicant. Hundred hour weeks, and then the papers after that. Out the door between four and five thirty in the morning with the kids asleep. Home late with the kids asleep.

By the time fellowship applications went out, nearly every joints attending at Beaumont was making calls for me. My program director. My chairman. They all picked up the phone.

Fourth year, I was back on his service. Same attending. Same OR.

He was close with the program director at Mayo Clinic. Mayo was my top choice.

I never told him I was interviewing. Never asked him for anything. I had already decided what his answer would be.

He heard me telling somebody else about the Mayo interview. Started asking questions. Where are you interviewing. What programs are you interested in.

I told him Mayo and Rothman.

Then he asked why I had never asked him for a letter.

Told him the truth. I didn't think he would want to write one.

Go to the interview, he said. If you really love it, I'll make the call. My name goes on the line.

He looked me right in the eye when he said it. His reputation. On me.

I promised I wouldn't let him down.

The match came through while I was at a conference. Hotel room. Brita on speakerphone. I opened the email hoping but not sure.

Matched at Mayo Clinic.

The Mayo program director was at that same conference. I bumped into him in a hallway, wearing shorts. He congratulated me on becoming a future fellow. Then he told me to thank my mentors. One in particular.

The man who told me I wasn't good enough had turned around and told Mayo Clinic I was.

I almost never asked him.

The good thing is a single yes in the middle of a hundred nos is the only opening you need. Earn it first. Then ask the person you are sure will say no.

Tell me your good thing this week. I read every one.