Patience, Positivity and Persistence


On my personal journey, I've learned a valuable lesson that applies to many facets of life: patience. As a physician, as an interventional cardiologist and even as an adult, frustration and anger are much easier, less refined reactions that can almost instantaneously consume any situation. Patience is a more polished and sophisticated skill that promotes a positive environment and self-growth. The following has been my approach, ever evolving, to understanding and obtaining a higher level of patience with those around me, and more importantly, with myself.

Patience is not only the ability to wait, but also the ability to wait while maintaining a positive attitude. I have found that to be the most difficult part at times, particularly during my interventional training. Many of us in the field of interventional cardiology are here to make an immediate impact, so the idea of having to wait can be frustrating. Whether you're a fourth-year fellow at your home institution, or a fresh face somewhere new, there is almost always an initial period of apprehension as your start your fellowship in the cath lab.

At first glance, the notion, as an interventional cardiology fellow, of having to observe, then perform procedures under considerable supervision can be a difficult pill to swallow. However, if you analyze the scenario more closely, after taking a deep breath and exercising patience, the picture slowly becomes clearer. You're a new interventional fellow, and trust must be gradually earned between yourself and each attending you train with. The threshold for each technique with each interventionalist is different, but in this field where patience can quickly wear thin, most attendings will take notice of fellows who exercise patience and poise.

Patience as a learner is valued greatly by teachers and mentors. The key is to try to stay positive as you practice patience, persistently showing up every day with an optimistic and grateful attitude. This type of energy is infectious and attendings, cath lab staff, and the general fellows will notice. You will also set an example for how to carry yourself when faced with adversity. As you progress through training in the cath lab as an interventionalist, your own ability to grow with patience is truly liberating and extremely satisfying.

More important than practicing patience with those around you, is practicing patience with yourself. Years of tireless efforts and sacrifice have put you in a position to help people and save lives. There is an undeniable but unrealistic urge to do everything and do it well from day one. In time, your role has expanded, and you've started to polish new skills, then without warning, it happens. Your first complication. All the patience, positivity and persistence has gradually moved you forward only for you to stumble down the mountain, seemingly undoing everything good you've ever done in your entire life. We all know this feeling. You immediately doubt your skills, training and accomplishments to that point, with the overwhelming fear of feeling unworthy. This is a specific form of intellectual self-doubt, the impostor phenomenon.

Recovery from these moments can be extremely difficult, and in these moments, I've leaned heavily on family, friends and my colleagues. After a complication, a thoughtful debrief with the team and self-reflection is essential as you try to learn from this and grow as an individual. There is something to learn from every case. We don't learn solely from experience, but from reflecting on experience as well.

An important part of self-reflection is learning to have more patience with yourself along the way. While it can be easy to discount your abilities and purpose in this field at the first sign of trouble, leaning on trusted colleagues and co-fellows may be a very purposeful way to place yourself in perspective and develop more patience with yourself, acknowledging all the hard work and sacrifice you've selflessly devoted to getting you to this point.

Patience has been my greatest ally, one discovered later in life but one I am grateful for daily.

I would be remiss if I did not acknowledge the support and mentorship of Brian C. Case, MD, FACC, and Stephen J. Green, MD, FACC, for guiding me.


This article was written by Giorgio A. Medranda, MD, FACC, an interventional cardiologist at NYU Langone Hospital – Long Island and a Clinical Assistant Professor, Department of Medicine at NYU Long Island School of Medicine. Twitter: @GiorgioMedranda.

This content was developed independently from the content developed for This content was not reviewed by the American College of Cardiology (ACC) for medical accuracy and the content is provided on an "as is" basis. Inclusion on does not constitute a guarantee or endorsement by the ACC and ACC makes no warranty that the content is accurate, complete or error-free. The content is not a substitute for personalized medical advice and is not intended to be used as the sole basis for making individualized medical or health-related decisions. Statements or opinions expressed in this content reflect the views of the authors and do not reflect the official policy of ACC.