Abstract

As part of a special collection of articles on women in academic medicine, the author reflects on her 50 years in medicine as a trainee, faculty member, administrator, and editor-in-chief of the Journal of the American Medical Association (JAMA). She uses personal experiences to illustrate several lessons learned. First, good leaders share 4 characteristics, each of which begins with the letter "T" (tenacity, tough mindedness-not toughness, thick skin, and tender heart). Second, never underestimate the ability to change things. Third, always keep a paper trail. Fourth, people will not remember what was said, but they will never forget how they were made to feel. Fifth, support that comes only from the top is actually a hanging. Sixth, losing one's vision might be worse than losing one's sight. And finally, some things can only be seen through eyes that have cried. The author closes with advice for women negotiating a first or a new position, and a reminder that whatever position one holds in medicine, it is part of the greatest profession in the world, affording its members the honor and joy of taking care of sick people.

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