How do you get to Carnegie Hall?

Updated: Jun 4

Okay, we all know the punchline. The only way to get to Carnegie Hall? Practice, practice, practice. But let us drill into the lives of four individuals who can provide a road map to enhance a skill set, to prepare us for opportunity. Four individuals, in two different countries, four different passions.


#1. The surgeon. The email the other day was totally unexpected and caught me by surprise. It was from Ethiopia, from a surgeon with whom I had connected several years ago. He reached out just to touch base and let me know that he and his family were safe despite the turmoil in that country.


I had met him while I was the attending physician on the oncology service years ago. This young surgeon accompanied our team on rounds for several weeks to become familiar with the administrative and organizational structure of care in an American hospital. His area of expertise was gynecologic surgery especially for advanced cancers. Our team was profoundly touched by his professionalism and his knowledge of the surgical techniques for very complex operations. He had an encyclopedic knowledge of the nerves, the blood vessels, the organs, and the muscles deep within the pelvis.


We naively thought that he had traveled from his home country to a major surgical institution either in Europe or in South Africa for his training. But because of finances and political chaos, he could not leave the country. We inquired where he developed these technical skills and with a wry smile, he humbly said, “I went to the University of YouTube!”


He had a passion to help these patients but could not access formal training programs so he would spend hours each night reviewing in slow motion and with closed captioning the intimate, complex minute-by-minute surgical techniques of the world’s greatest surgeons. His expertise became widely recognized in his home area and he was a model of tenacity and perseverance.


#2. The golfer. She was a seventeen-year-old high school student who was on her way to play golf in the US Women’s Open to be held on the West Coast. The probability of having the skill set for this tournament was miniscule especially for someone so young. But a newspaper article emphasized that there is no free lunch.


She would play golf on the practice course for approximately six hours each day, six days a week, and then back to the driving range for in-depth instruction and analysis of swing, stance, grip, and course strategies.


Her competition were older family members as well as far more talented golfers from the community who pushed and prodded and intimidated her to reach an incredible pinnacle of golfing excellence.


#3. The baseball player. Growing up, especially on the East Coast, I came to know that baseball was king. Every kid imagined pitching game 7 of the World Series. But let us be realistic. The odds of that happening are astronomical but this story shows what is possible.


Following a spectacular high school baseball career in small-town America, this pitcher was passed over by college baseball powerhouses. So he enrolled in a two-year junior college, which offered very little support for baseball, long bus rides, and a road to obscurity. But he hustled, refined his craft, and helped this backwater school to a championship, and he himself earned an all-American recognition with his spectacular record and incredible performances on the mound.


He could have easily given up, but his perseverance led to a scholarship at a four-year college. Yet he knew that was not enough. He too accessed YouTube and Twitter and identified through trial and error the world experts on how to throw a baseball that virtually no one could hit. He refined the art of pitching by using weighted compressible baseballs. He jumped at the possibility of playing in a league of college-age players, each of whom were hoping for the ticket to the big time.


#4. The doctor. Almost every advancement in medicine and surgery started with a curiosity, perspective, an insight from a curious practitioner who was not satisfied with the status quo. In the early part of the 1900s, the Mayo brothers from Rochester, Minnesota, were not satisfied with the delivery of healthcare, which then was a disorganized mom-and-pop business where physicians independently kept the records of their patients.


There was little collaboration, little integration. So the Mayo brothers devised an integrated group practice where there is a common medical record and patients saw multiple physicians. This changed delivery of healthcare for the world. But another physician in the 1990s was still not satisfied.


He was a general internal medicine physician from a large clinic in the West. He was increasingly frustrated by inconsistent laboratory results, which could not be relied on for clinical decisions. He was dissatisfied by complex patients’ schedules where they would see one physician on a Monday, return on Wednesday to see another doctor and then return for final wrap up after another week had gone by.


“There has to be a better way,” he said to himself.


He scoured the Internet and found a program on systems, procedures, and project management on the topics of quality, safety, and reproducibility of clinical care. This was no mail order diploma. For approximately three months, using his own time and resources, he drove two hours round trip to a business school, Monday through Friday, for a formal didactic program, punishing workshops, and coursework on the weekend. And a blistering defense of his thesis. He essentially earned a mini-MBA in three months compared to the usual eighteen-month grind.


When he returned to his home institution, colleagues would often ask, “How did you get to be so smart?”


He humbly said, “I guess I just got lucky.”


But Lady Luck took a holiday and had nothing to do with his expertise.


These examples are hardly rocket science or brain surgery but they underscore consistent fundamental “truths.”


1. The prodigy, the once in a million performer, the athlete with the gift from the gods is essentially a myth. No one gets to the Pantheon of Greatness without consistent, dedicated, uninterrupted focus with clear guidelines of progress. And under the watchful tutelage of a mentor, a coach, a guide.

2. The willingness to grind it out in the cold early morning dawn, no lights, no cameras, no endorsements. No agents.

3. How badly do we want accomplishments like these? Are we willing to carve out the time in the sacrifice to make it happen?


What's your passion?







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