Life By Design
by JOHN DAVID KOLTER , MD This essay was a submission to the 2024 Richard Spear , MD , Memorial Essay Contest .
The journey of medicine is a long , but , not necessarily , strange trip . The path to becoming a physician traverses many academic straightaways comprised of linear learning , followed by the deductive and inductive reasoning of medical practice . Moreover , the much vaunted art of medicine is less a foray into creativity and more a learned sixth sense , a je ne sais quoi , if you will . Certainly , practicing medicine provides satisfaction that comes with meaningful , cognitively challenging work . However , a physician with a busy and creative mind can ’ t help but , at times , wonder about the ones that got away on the more circuitous roads in life .
My alternate , and possibly more tortuous , path begins with my 8-year-old self who was determined to become an architect . As an elementary school age boy , in my free time , I created “ blueprints ” with a graphite pencil on scrap paper , amassed in a prized collection . This hobby was certainly no secret , as I was overtly proud of my creations . My great uncle , a well-respected architect and aware of my architectural reveries , sought to nurture my interest . In his generosity , he invited me on an architectural tour of some active projects in the construction phase around our city .
I still remember that warm fall day vividly . We met early in the morning at his mid-century modern hillside home with the promise of a design bacchanal ahead , the closest thing to drunken revelry for a kid who drew blueprints for fun . We set out , he in his blazer and I in my best pleated khakis , gliding downtown in his sleek , imported-to-order Jaguar convertible . We hopped from one construction site to another , touring projects emerging from blueprints to actual , physical structures . We lunched , at my choosing , in the revolving restaurant at the top of the Hyatt hotel , a signature , of which I was obsessed , of the Hyatt brand at the time . My great uncle was my architectural archetype and I was smitten . At the conclusion of the day , I was certain I was destined to be an architect and felt the distinct possibility that my blueprint doodles would one day be brick and mortar .
20 LOUISVILLE MEDICINE