First Violin

First Violin

George W. Sledge, MD, FASCO

Mar 31, 2011

A few nights ago, I had the pleasure of attending Carnegie Hall in New York City, where I heard a concert by the Toronto Orchestra, with a guest solo by the famed violinist Itzhak Perlman. Perlman was magical, a true delight to listen to. My first thought that night was that God puts certain people on this earth just to humiliate the rest of us. I have had that thought a few times before, in different venues: seeing Michelangelo's statue of David in the Accademia in Florence, and watching Michael Jordan in the NBA finals, or being absolutely devastated by Goya's Tres de Mayo in the Prado, or reading any of five or six of Shakespeare's great plays.

I could practice the violin for 500 years and not sound that good. I do not mean to undervalue the importance of practice and experience, which are clearly important even in grand masters. But I suspect that the Perlmans of the world are wired differently than you and me, continuing evidence that life is simply not fair and never will be.

When Perlman left the stage he shook hands with the concertmaster (the leader of the first violin section).  What is it like to be concertmaster for a major symphony orchestra, a respected professional, a leader in one's group, and likely head and shoulders above most musicians based on talent and experience, and have to sit through a Perlman solo? Is one exhilarated or depressed? Ennobled by being in the presence of a wizard, or saddened by the knowledge that one will never quite reach that level of excellence? For a moment I felt sorry for this man I had never met, until I realized he was us.

Physicians are natural concertmasters, the “first violins” in health care organizations, and their societies (including ASCO) are naturally aggregates of first violinists. We have very few wizards. Medical science, indeed most science, proceeds perfectly well without supernova talent. It depends on collaboration and incremental development of the knowledge base. Very few medical historians think that the structure of DNA would not have been discovered had Watson and Crick decided to study the ecology of penguins as opposed to molecular biology, nor even that the discovery of the double helix would have been delayed all that long. The idea was in the air. A fair number of the distinguished scientists I have met in my career were distinguished primarily for being in the right place at the right time. Smart, yes, hardworking, yes, but magical, no. Genius, in my experience, is an overused word.

I'm OK with this. I like there to be some predictability to our scientific future, predictability in the sense that nature's textbook will be read and understood by ordinary mortals rather than requiring some other-worldly high priesthood. There is something providential and miraculous about the great ones, and I would rather not have to rely on the providential and the miraculous for my daily bread. The everyday workings of modern science are enough to sate my intellectual hunger and practical needs.

But at the same time there is part of me, and I suspect part of most of us, that would love to strive for that special mastery, that incandescence that lights up and changes everything. And (so long as I am allowed to dream) I would like our professional Society to strive for that special something as well. Maybe, just maybe, all us first violins playing together can create something truly miraculous, unique and lasting. At least we can try.


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Anees B. Chagpar, MD, MPH

Apr, 10 2011 2:37 AM

George -- this is, IMHO, your very best blog yet!

To all of the first violinists out there: When you're in the presence of greatness, never be saddened in the assumption that you will "never quite reach that level of excellence". Pearlman was brilliant, I am sure . . . but he too started somewhere. Who knows? Perhaps he, too, was once a first violinist who felt humbled in the presence of a master . . . With the nurturing of teachers and mentors, the support of family and friends, the backup of an outstanding orchestra, a tonne of hard work and practice, and hopefully some inherent talent, greatness is achievable. As mere mortal "non-wizards", we need to remember that, and be inspired by those who have achieved such stature. I was in Turkey recently where I met Idil Biret, a world famous pianist, who told me how she started playing at the age of 4 . . . she has God-given talent, to be sure, but she practices hours every day, critically evaluating every note of every piece, pondering how to improve . . . it is this constant quest for unattainable perfection that allows us to reach beyond what we may have considered our limits. George, it is not only allowable, but incumbent upon us to dream -- and I would argue that the lack of having big, hairy, audacious goals as Jim Collins puts it in “Good to Great” -- one of my all-time favorite books -- is a critical element that leads to stagnation in the status quo. Thanks to you and the rest of the leadership who push the vision for our organization, I am certain that ASCO will achieve something even more "miraculous, unique, and lasting" . . . it's not a maybe. It's a definitive.

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