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8 CUAJ %u2022 FEBRUARY 2025 %u2022 VOLUME 19, ISSUE 2 Leveridgelance has enriched nearly every clinic. A mote of dust enters my eye now and again when I give the %u201cgolden high-five%u201d and graduate a patient from followup.It is, of course, not all heart-to-hearts and crisp daps. Pain, it%u2019s-not-pain-it%u2019s-more-discomfort, LUTS and wakeups, ED, and the lot shred quality of life and can breed unachievable expectations, sentinels of imperfect or aging psychology and physiology that some can%u2019t abide. Every field has its albatrosses; ours is no exception. I find it helpful to acknowledge the limits of our diagnostic and therapeutic tools as a reliable defuser.%u201cThis staggering variability within the field of urology presents equally as many options for practice in a general or a tailored career%u2026My personal preference at this time is to advance via fellowship training into a specialized career in an academic setting.%u201dI had no crystal ball here. Feigning fidelity to academics is the safe move, and an unfair one. Community urologists are the providers of the bulk of urologic care %u2014 and the actual purpose of residency training %u2014 and it%u2019s disheartening to think that it takes courage to state non-academic aspirations. My program director, Dr. Siemens, will recall that I deferred career planning until he helped hook up a fellowship; I love my town and simply glommed onto it and got very lucky. As with most jobs, it was serendipity over strategy: Dr. Morales%u2019 impending retirement, Dr. Kawakami%u2019s departure westward, and suddenly a spot. What I love about my practice is less the specialization than the teaching environment. It keeps me accountable, keeps me learning, and taxes my presentation and thinking skills. Lecturing, modeling, course-correcting, explaining, quizzing; these are self-improvement skills (remember %u201clifelong learning%u201d from your med school application?). Next, I basically tried to say I was smart, then...%u201cI am aware that a copy of Campbell%u2019s thrust into a patient%u2019s lap will do little to address his or her reason for visiting the urologist, despite the facts inside (though the local orthopod would be thrilled to repair the femur fractures)...the establishment of rapport is the critical step in ensuring that the clinical encounter is a success in any respect.%u201dThis is obviously true and in the long game, the source of much fascination, frustration, and curiosity. I%u2019ve evolved in that I no longer model the doctorpatient relationship as [knowledge + people skills = good outcomes]. An awareness of the patient%u2019s models %u2014 available anecdotes, values, expectations, and antibodies %u2014 shows the actual starting line and obstacles between their issue and its resolution.4 Plus, it%u2019s not so much the weight of textbooks shattering femurs in 2025, but the hot laptop slow-roasting gonads ;).%u201cI believe that the qualities that make me an effective student and that will make me an excellent physician can be traced in some measure to my longstanding participation in team sports%u2026I have had to assume several different roles, from counted-upon leader to stone-handed pylon, which have demanded that I find a way to achieve the goals of the team by identifying and exploiting those skills that I do have and appreciating the role of others whose proficiencies differ from and improve upon mine%u201dNo notes. Urologic care is a team sport, and 15 years in practice is plenty to see the difference between flow and friction.%u201cI believe very strongly that a surgeon cannot be content nor competent without maintaining roles and obligations outside of the hospital, not simply as %u201cstress relief%u201d or a break from work but as important and independent entities. As I look forward to a career in urology, so too do I look forward to more nights of waxing philosophical over pints with friends, summer baseball games, travel, establishing a family, and playing a role in my community%u201dDaring to inject work-life balance into a letter in 2002. In order: yes (but nocturia, so %u201csort of%u201d), yes, sort of, yes, and sort of (they know I like 50 in one bar and Green Chartreuse in another, does that count?). This is really me saying that antidotes to burnout predate its well-deserved time in the spotlight, and I can get as mired as the next person. You will never be on top of all the work and are not so essential that you shouldn%u2019t flip over the closed sign here and there.I could go on. But I%u2019ll end with this. My letter is just like yours was, and we were right. How lucky we were to discover urology, and how lucky someone gave us the chance.REFERENCES1. Leveridge M. Groundhog clinic. Can Urol Assoc J 2024;18:7-7. https://doi.org/10.5489/cuaj.87172. Leveridge M. Leaving the room: A method of patient-centered care? Can Urol Assoc J2024;4:79-80. https://doi.org/10.5489/cuaj.87673. Leveridge M. Cancel half of your clinic visits* (a Halloween hot take). Can Urol Assoc J2024;10:295-6. https://doi.org/10.5489/cuaj.89964. Leveridge M. Communication breakdown, or clashing models? Can Urol Asoc J2024;12:367-8. https://doi.org/10.5489/cuaj.9061CORRESPONDENCE: Dr. Michael Leveridge, Department of Urology, Queen%u2019s University, Kingston, ON, Canada; Michael.Leveridge@kingstonhsc.ca