By John Howe ’16

A

t 5:00 a.m. in July 2014, I stepped out of the pediatrics workroom on the fifth floor of the Loma Linda University Hospital with a patient list. I was a third-year medical student. In the slowly awakening hum of the hospital, I felt lost and alone.

At that moment, an attending passed me in the hallway, then stopped, turned, and scrutinized the name on my lapel.

Anees J. Razzouk ’82 then warmly introduced himself and explained how he had seen me standing the previous day in the Ontario Airport, awaiting my wife in the passenger terminal with a bunch of roses. We laughed together at this coincidence, but before he turned to leave, Razzouk pulled a card from his wallet and wrote his cellphone number on the back. His next words remain fresh in my memory: “John, if there is ever anything I can do to help in your training, please let me know.”

In the following weeks and months, I often joined Razzouk to watch in wonder as he operated on the hearts of tiny infants and children. Here amidst the sterile sacraments of the operating room, a division chief sketched reconstructive cardiac anatomy on the back of a scrub card for a wide-eyed medical student. I observed in him unsparing focus and commitment born of love for his patients that has been a source of enduring inspiration to me and has deeply influenced my practice of medicine.

Later in my third year, I bumbled into the office of another division chief. My mission was to pitch various schemes to Douglas R. Hegstad ’80-A, chair of medicine, to study and apply principles of resilience to combat medical student burnout. As I babbled, Hegstad listened intently, without a trace of impatience or annoyance at my extemporaneous splashdown in his packed schedule. In the course of that meeting, I somewhat improbably asked Hegstad if he would help me get my head around my still conflicted attractions to medicine and surgery. He agreed, and in many following meetings, he patiently listened and told a few stories, helping me to make sense of my own story along the way.

As I reflect with gratitude on the impact of the many mentors in my life and path through medicine, I am reminded of a quote attributed to Avedis Donabedian, a founding father of quality assurance in medicine, in an interview published posthumously in the journal “Health Affairs”: “Ultimately, the secret of quality is love. You have to love your patient, you have to love your profession, you have to love your God. If you have love, you can then work backward to monitor and improve the system.”

I believe the secret of quality, as framed by Donabedian in reference to healthcare systems, applies in equal measure as the secret of education and resilience. I say this with profound gratitude to those who, in the course of my training, showed me why—and in the process, that made all the difference.  ν