My Internship as a Referee

My Internship as a Referee

William S. Loui, MD, FACP

Jun 25, 2013

I looked ridiculous.

Dressed in the black-and-white-striped soccer referee shirt, I looked like roadkill on a black asphalt road with the white sidewalk markings. It reminded me of how uncomfortable I looked in my interview suit and tie as a medical student interviewing at residency programs. Little did I know that I was in deep trouble. As they say in Hawaii, I was in deep kimchi. I had volunteered to be a referee in the youth soccer league.

On one previous Saturday morning, we had a soccer orientation and a quick introduction to the soccer rules. We ran through the basic format, time limits, safety measures, and mystery of the offside rule. I thought to myself, I’m sure that I am going to forget everything once the game starts.

Then they distributed the referee shirts; it was 100% polyester, tight, and hot. The patch would not stick on the Velcro on the shirt. The collar choked me if I buttoned it up. The long black soccer stockings squeezed my legs like pythons all the way up to my knees. But the whistle, hey, I could do that!

Yet I was out of my depth and experience. It was a flashback to my internship year in which I had felt like a fraud. Everyone else appeared to know what to do. For the first few months as a newly minted doctor, I struggled to figure out the rules of the game.

In my anxiety over my internship as a referee, I easily imagined the sidelines filled with parents yelling, kids running into each other, and coaches screaming. It was everything I had feared.

In that first game, I must have blown that whistle a hundred times.

And I forgot to have a coin for the coin toss to begin the game.

And I sweated down to those black soccer socks.

And I needed eyes in the back of my head to follow all the action. The exhaustion of running for the entire game was replaced by a sense of relief when it was over, for I had survived. My first day as a ref was like my first day on call as an intern.

But, at the end of the game, the kids were smiling. They lined up to shake hands with the other team in a display of good sportsmanship. The proud parents were applauding a 2-2 tie. The coaches thanked everyone. Someone gave me a cold bottle of water for my thirsty body. It was good to see healthy children enjoy themselves!

In time, I embraced soccer and its rituals. I wanted to be a better referee, so I studied the rules and watched soccer games. I came prepared. I learned to be in position to make good calls. I learned to anticipate plays and make good decisions quickly. I learned to be less controlling with the whistle and to let the kids have fun.

Each game became a teaching experience rather than a chore. In addition, I learned to trust the line referees and appreciate their help. Finally, as a referee, I needed to be fair in my decisions. I started wearing a white cap, because the good guys wear white.

We encouraged the important life lessons of sportsmanship, teamwork, and positive coaching. At the beginning of each game, the young captains came out to shake hands and hold the coin toss. Now I was ready with my coin. The night before the game, I would put into my shirt pocket a big silver dollar for the coin toss. It was my good luck talisman; it also symbolized the importance of chance in life and games. In time, I rarely used that whistle and let the athletes play soccer.

I still need many of these skills as a medical oncologist, including the need for eyes in the back of my head. Fortunately, our great nurses, staff, and doctors are those eyes to see what I cannot see. I have learned to be prepared by knowing the latest studies, to be in position with good information in order to make good decisions, and to be fair with others. I trust my colleagues for their expertise and decisions. In the end, I have to act like the referee with a white cap, because the good doctors earn their white coats.

Last week, while collecting clothes for donation, my wife found my old referee shirt that had been tucked away for years. It was still too tight, too hot, and the patch had gotten lost over time. Disconcertingly, the vertical lines bulged out over my belly rather than fall in a straight vertical. Some day, when I look down, I hope to see my toes again.

“Are you going to keep this old shirt?” asked my wife.

“Darn right, I’m gonna keep it,” I replied.

I earned it.


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David L. Graham, MD, FASCO

Jun, 25 2013 12:23 PM


It's so good to have you join us with your insights on how life affects ourpractices and vice versa. I look forward to reading more

Michael A. Thompson, FASCO, MD, PhD

Jun, 27 2013 12:26 PM

Great post.
I have great respect for the dads (and moms) that volunteer to coach my kids while I'm still at work.
The recall back to internship is something I think all MD's can appreciate.
Especially those that did internship pre-work hour rules days...


Don S. Dizon, MD, FACP

Jun, 30 2013 10:22 AM

Dear Bill,

Enjoyed your post, especially on the insights on life's lessons. Oncology is very much a team endeavor- and the values you espouse, including camaraderie and respect, are so important in life and in medicine. Great seeing you here!


William S. Loui, MD, FACP

Jul, 01 2013 7:12 PM

Thanks for the feedback!
July 1st, our new residents started today.
Oh yes, he circle of life begins anew.

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