I

vividly recall the young dentist with a brain tumor, whom I admitted as a sub-intern during my medicine rotation in my fourth year of medical school. His unfortunate clinical course profoundly influenced my initial decision to pursue neuro-oncology as my specialty. He was a gentle giant with the physique of a football player but the most soothing voice. Diagnosed with a malignant, inoperable brain tumor, he was hospitalized due to an impending brain herniation. His wife was by his side throughout his hospitalization, and one evening, when I was going off-duty, he asked her to stay with him through the night as he feared he wouldn’t survive until morning.

It broke my heart to hear him express that fear, and to witness his wife trying to reassure him while leaving the room. The next morning, I found out that he had passed away overnight. In a way, I was relieved not to have seen his wife that day. This tragic death of a young person solidified my decision to pursue a research career in neuro-oncology, hoping to find better treatments for brain tumors. I joined a neuro-oncology group, consisting of neurosurgeons, oncologists, and basic scientists, and perfected a mouse model for the slow local release of medications from an Omaya reservoir.

The following year, on the first day of my internal medicine internship, I admitted my first patient, who was suffering from severe chest pain due to unstable angina. He was taken to the cardiac catheterization lab immediately after admission and returned completely asymptomatic in about an hour. I was so impressed by the swift and successful intervention that I inquired about the field and immediately decided to pursue interventional cardiology. I spent all my elective time during residency to perform animal studies in cardiology, and searched and found my mentor in interventional cardiology, who was one of the founders of interventional cardiology in America and who had the individual interventional volume of a sizeable academic program. He taught me not just the skills but the passion for helping those with coronary artery disease. Some may say that I strayed from my initial vow to contribute to the better treatment of brain cancer, but my desire to help patients in need did not change and my passion for interventional cardiology grew steadily with more treatment options and evidence-based approaches.

Although the interventional cardiology fellowship was grueling, with many sleepless nights, I was also able to continue my animal research, with contributions to the concept of drug-coated stents, the current standard of care and to perform data-base driven clinical research, with findings resulting in distal embolization protection during saphenous vein graft intervention. I have also enjoyed multiple leadership roles, where my main goal was to improve patient care and to provide as many treatment options as possible. Now I am back to my original role as a busy clinical interventional cardiologist, and still enjoy my work, probably more than when I began my career 31 years ago, with my experience, skills, and judgment as well as the genuine approach to above all reassure my patients even if there are limited interventional treatment options. I still have emergencies at all hours of the day, but I find immense satisfaction in helping patients with acute coronary syndromes at any time of the day. At a time when physician burnout and early retirement are not uncommon, I am grateful that my passion for interventional cardiology, sparked on the first day of my internship, has sustained me throughout my career. I still look forward to helping my patients in the cath lab every morning and even when I go in overnight to help those with STEMI, I have just as much anticipation in being able to relieve their symptoms and hopefully improve their survival as when I finished my fellowship decades ago. I just became a senior citizen this year, but I am not thinking about retirement soon as I still feel I can help patients with my decades of experience and skills, and I don’t feel the burnout as I get so much emotional reward from my work.

There are countless specialties and subspecialties in medicine, and as my journey illustrates, choosing a specialty driven by passion is paramount. By doing so, we can enjoy long, fulfilling careers and stave off burnout.