During an academic discussion recently, a colleague said that to be a physician requires quite a bit of resilience. I nodded in agreement. He mentioned the fact that several hundred doctors commit suicide each year and wondered what makes some physicians resilient to the pressures of work and life and others not.

This is an interesting question to ponder because it goes to the root of who we are as individuals. To make it through college, medical school, and residency requires above-average resiliency. There are those, however, who after entering practice become disillusioned and depressed and cannot persevere.

Is the problem fatigue from having to repeatedly pick oneself up out of the mud, or is it the surprise of finding oneself in the mud at all? I believe that it is the latter. Everyone, to some degree, had the expectation that professional life would be grand once residency was completed.

There is no doubt that life is better after residency, but few can honestly say that no unwelcome surprises came along. It’s the other guy who gets sued. I’m not the one who will be treated disrespectfully by a colleague. It’s some other person, not nearly as smart as I am, who will get cheated in a business arrangement.

If I’m running an obstacle course and I see three out of four people ahead of me fail to clear a water jump, I won’t be surprised if I’m all wet before I finish. But if I set an unrealistic goal of running the course without getting dirty, I’m sure to be disappointed and possibly disillusioned.

This is where the quality of perseverance comes in handy. Combined with a bit of street smarts or horse sense, perseverance can lead to many successes.

When I was a scoutmaster for our local Boy Scout troop, I spoke often of perseverance. I told the boys that intelligence, good looks, money, and connections will get you only so far. Sooner or later you are going to fall flat on your face and nobody is going to pick you up. The successful person is the one who falls down 9 times and gets up 10.