What Is the Point of This Piece?

This Resident Roundup post comes from Sean Pirkle, MD, who is a fifth-year resident with the Department of Orthopaedic Surgery and Sports Medicine at the University of Washington, Seattle.  

It was the summer of 2016, and I was living in a shoebox with 3 other strangers in New York City. Most of my days were dedicated to pipetting microliters of some solution that I can no longer remember onto descendants of HeLa cells. In the evenings, I would walk home and park myself in the basement of my apartment complex and start chipping away at the secondary applications to medical school that were piling up on my to-do list, writing about failure and ethical dilemmas and racking my brain for good examples of interpersonal conflict, which I tended to avoid altogether.  

When the summer ended, I had spent dozens of hours reflecting on my life and the decisions I had made that led me to medicine. I had ruminated over my mistakes and successes and drawn arguably meaningful conclusions from them. I found that I enjoyed the form of slow thinking that writing offered; it was a welcome change of pace from the daily grind of pre-medical studies.  

My first creative piece was a short essay imagined from the perspective of a little boy with a learning disability who was watching his mother attempt to raise him. I submitted it to multiple writing competitions and never heard back. Undeterred, I took with me this appreciation for writing when I began medical school. I started documenting everything around me: the good, the bad, the moments of self-doubt, the reasons for celebration. Over 4 years, it grew into a larger body of work that serves as a window into a hidden world, brought to life by the challenges, triumphs, and failures unique to modern-day medical training. My debut book, Somewhere in Between, had become something significant, and, in my humble opinion, good.  

I think my journey with writing has helped get me through residency: not just by providing a means to reflect on the hurdles that residency throws at me, but by giving me experience with failure. I have had to “kill my darlings” and throw parts of me in the trash. I have shared new creations only to receive criticism (and the critics were usually right). I have been rejected by more agents than I care to share with the internet.  

For me, writing is just an extension of this person who is always trying and rarely succeeding, and, fundamentally, this is also the experience of orthopaedic surgery residency, where most days feel like failure. I don’t think that this is a bad thing because if we are not failing, in some sense of the word, then we are not growing. And my truth is that I have failed so much that it no longer scares me. I think that it is easy to feel personally victimized when we are criticized, corrected, or straight-up told we are wrong, as though the very act of feedback is some kind of attack on our intellect and character. These days, though, sitting where I am now as a chief resident at the precipice of fellowship and beyond, I have assumed a new role as a “provider of negative feedback.” It sounds corny to say out loud, but I can confidently assert that every bit of feedback I deliver is not to tear others down, but to make my juniors better clinicians and better surgeons. I don’t think that I fully appreciated that my seniors and attendings felt the same way until this final year of residency training. 

I wrote an article during PGY1 that would later become a launching pad for me to participate in broader conversations about physician wellness, health-care access, and equity. The first journal I submitted to provided the following feedback: “What is the point of this piece? To raise the issues of self-doubt, insecurity, lack of teamwork, poor leadership, poor teaching of residents by faculty? There is no clear theme here.” 

Failure, it turns out, has been one of my most consistent teachers. It forces clarity. It demands humility. And, in my case, the power it holds over me is derived, not from fear, but from its ability to help me grow. 

Sean Pirkle, MD  

Interested in being published on the JBJS OrthoBuzz blog? Residents and other trainees are invited to submit a post to Resident Roundup. Share your experience, connect with others in orthopaedic training, and add your viewpoint to the orthopaedic conversation. Find out more here. Questions and submissions can be sent to: orthobuzz@jbjs.org   

More Posts from Resident Roundup:

A Year in Review: The 2024-25 JBJS Robert Bucholz Resident Journal Club Support Program  

Turning the Flywheel: Building Balance Through Consistency in Residency  

A Year of Growth and Gratitude at Rady Children’s Hospital, San Diego