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“Twenty years from now you will be more disappointed by the things that you didn’t do…

by U.S. Medicine

October 6, 2017

“Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.” – Mark Twain (1835-1910)

Editor-In-Chief,
Chester “Trip” Buckenmaier III, MD,
COL (ret.), MC, USA

Pam, our friends Karon and Toni, and I had been looking forward to a week sailing our Gemini 105Mc catamaran, Family Knot, exploring the Chesapeake Bay.  We left on a Saturday with the idea of cruising overnight to see how far south on the Bay we could get before leisurely sailing back again, visiting points of interest along the way.

  Sailing overnight in the Chesapeake is tricky, for unlike open-ocean sailing, there is much on the Bay to avoid, and the added element of darkness complicates the equation.  Hazards range from poorly marked shoals, unlit buoys and fish-traps, fluky weather, and the constant threat of massive cargo ships that ply this active commercial corridor. Yes, as a sailboat we have the right of way, but one does not argue with a 200-ton cargo ship that can neither slow nor turn to allow for a pleasant conclusion to the seagoing altercation.

A Bay sailor can avoid or minimize all of these headaches by sticking to day sailing in pleasant conditions. There is much to be said in favor of the day sailing approach.  Wear and expensive repairs are markedly reduced by not subjecting the boat to weather extremes. Crew stress is almost non-existent, and the day ends with the boat back safely in a familiar dock in time for dinner and drinks. 

While I am a proponent and practitioner of this approach to sailing, admittedly you never really get anywhere beyond the waters surrounding your homeport. I do not get the same sense of satisfaction in my skills as a sailor, my ability to move the boat and crew safely from destination to destination regardless of the conditions, as I do when we set out to new locations over the horizon.

Taking the boat out on a distance cruise and successfully navigating through the many hazards mentioned in whatever weather the Bay conjures up is a feeling of personal accomplishment with which few other activities in my life outside of medicine can compete. There are significant risks to this approach, the wear on ship and crew considerable, and the possibility of disaster not insignificant.  So one might rightly ask why any rational person would put the boat and crew at risk if there was no clear need to do so. The answer simply stated is, “You cannot achieve new and distant shores without risking the seas in-between, despite the fact that those seas can often be stormy and may contain hidden dangers.”

Such was the case as Family Knot cruised south on a comfortable broad reach on a steady breeze out of the north. Our plans to continue south down the Bay overnight were suddenly thwarted as a large thunderstorm developed behind us and began (seemingly) to chase us down the Chesapeake.  I was aware of the deteriorating conditions because although there is always risk in cruising, the prudent captain can leverage technology to manage risky situations in the crews favor.  As the captain of Family Knot, I have invested heavily in safety equipment for the boat that allows me to, as General George Patton would say, “Take calculated risks.” The boat has a modern chart plotter that accurately reflects my position, it is equipped with an automated identification system (AIS) that identifies local commercial shipping traffic and keeps me on their radar, and I have real time satellite weather to accurately track dangerous storms.

Our plans to quietly sail down the Bay overnight were not to be, but more importantly the crew and I had plenty of time to secure the boat for heavy weather and seek a safe harbor to overnight and allow the storm to pass.  Despite all of this technology, the race to get to a sheltered cove to anchor was a bit more exciting than I would have liked.  As the sun set we could see the angry clouds and lighting strikes bearing down on our little boat.  To ease the tension we all broke out in a horrible rendition of the opening theme to Gilligan’s Island – “The tiny ship was tossed! If not for the courage of the fearless crew…” Obviously since I am writing this we did not end up like the S.S. Minnow, but it was a stressful event, with visibility being reduced to one foot (thank you GPS gods) by driving rain before we could get the vessel to anchor. 

I am relating this story because it reinforces an idea that I feel we in federal medicine often forget.  To achieve anything better for our patients and our system we must be willing to take personal risks and tolerate those around us who are taking risks.  If we never challenge the system, opting rather to remain safe behind tired policies and old comfortable ideas, we will never achieve the benefits of arriving at new and innovative shores.  There are risks involved and failure is a possibility but the road to success and improved patient care is paved with those risks and failures. 

Although I would never tell my crew, that thunderstorm scared the hell out of me, and we never did make it to the lower bay as planned. While our original mission was a failure, we were challenged as a crew, we adapted and rose to the challenge successfully – a very satisfying result.  In the end the bad weather and change to our plans did not matter as the sailing was delightful the next morning and the rest of the cruise a great success — and I certainly became a little bit better of a sailor from the experience.  I have spent a career taking risks with some modest success and some spectacular failures, but I agree with Twain, my only regrets now are the risks I did not take because I decided to stay home in a “safe” harbor.   


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