Anemia In Academia: Part 8 - The path forward (#545)

Force #8: Reclaiming purpose.

After weeks of writing about loss, I found myself asking a simple question:

Is this just nostalgia?

Am I merely longing for a past that can’t return?

It’s an easy trap. Especially for those of us who have been around long enough to remember different eras, different rhythms, different ways of working.

But I don’t think that’s what this is.

This isn’t about going backward. It’s about remembering what mattered, and choosing, deliberately, to protect it again.

Every clinician I know can recognize anemia in a patient.

You don’t always need the lab work. The signs are visible:

Fatigue

Weakness.

Poor recovery.

Loss of vitality.

That’s what academia feels like right now. Not dead. Not broken. Just… pale. Tired.

As though something essential has been drained away, little by little, year after year.

And like any good clinician, the first question isn’t Who do we blame?

It’s What can we restore?

Because here’s the hopeful truth:

None of the forces we’ve talked about are inevitable.

They’re not laws of physics.

They’re choices.

Organizational choices.

Cultural choices.

Leadership choices.

And what has been chosen one way can be chosen another.

If money was the first force, then fairness is the first repair.

We don’t need academic salaries to match private practice dollar for dollar.

But we must stop asking people to make heroic financial sacrifices simply to teach.

Service should not require martyrdom.

Reasonable compensation says something very simple:

We value you.

Sometimes that message matters as much as the number itself.

If bureaucracy was the second force, then simplicity is the antidote.

Fewer approvals. Shorter chains. Less performative oversight. More trust.

Not every decision needs a committee. Not every action needs a form.

Give faculty back their time and you give them back their energy.

Time, more than money, is the true currency of academic life. Protect it fiercely.

If burnout drained us, then focus must heal us.

The quadruple mandate has quietly become a quintuple or sextuple burden.

No one can do everything well. So, stop pretending they can. Let some faculty primarily teach. Let others primarily research. Let others focus on clinical excellence.

Depth is better than fragmentation.

When people can concentrate on what they love and do best, energy returns almost immediately.

Purpose follows focus.

If autonomy was lost, then trust must be rebuilt.

Move decisions closer to the clinic floor. Closer to the classroom. Closer to the people who actually understand the work.

Trust professionals to act like professionals.

It sounds almost naïve. But it’s powerful.

When people feel trusted, they rise.

When people feel controlled, they withdraw.

Universities should be communities of judgment, not systems of permission.

If metrics replaced meaning, then we must remember to value what cannot be counted.

Promotion systems that recognize mentorship. Time protected for teaching. Credit for clinical wisdom, not just citations. Reward the faculty member who stays late with a struggling student just as much as the one who publishes another paper.

Because decades from now, it won’t be the paper students remember. It will be the person.

We must design systems that reflect that truth.

If mentorship has quietly disappeared, then we must create space for it again.

Not programs. Not modules. Space. Unstructured, human time.

Shorten the schedule. Reduce the overload. Encourage walking together between cases.

Encourage lingering. Encourage conversations that have no agenda.

Mentorship cannot be manufactured. But it can be protected.

And once it returns, the culture changes quickly.

Because connection is contagious.

And if moral injury was the deepest wound, then alignment is the cure.

Say clearly what we stand for:

Students first.

Patients first.

Integrity first.

Then make decisions that actually reflect those words. Not branding language. Not strategic slogans. Real choices. Transparent choices.

Faculty can tolerate long hours and modest pay.

What they cannot tolerate is hypocrisy.

Trust is rebuilt when actions match values. Every time.

I sometimes think back to the best days of my own career. Not the awards. Not the titles. Just ordinary days.

A student finally understanding a neurological exam. A resident mastering a difficult surgery. A quiet thank-you from an owner whose dog we helped. Walking out of the hospital tired but certain that the day had mattered.

That feeling - that quiet certainty - is purpose.

It is why many of us stayed in academia for decades.

And it is still possible.

We haven’t lost it forever.

We’ve just buried it under layers of process and pressure.

Reclaiming purpose doesn’t require revolution. It requires subtraction.

Less noise.

Less control.

Less counting.

More trust.

More time.

More humanity.

Strip away enough of the unnecessary, and what remains is what was always there:

Teachers who want to teach.

Clinicians who want to heal.

Students who want to learn.

That’s the heart of a university.

It always has been.

The halls of academia are not empty because young veterinarians lack heart. They are empty because we have made it too hard to keep one.

But hearts are stubborn things. Given oxygen, they recover. Given trust, they strengthen. Given purpose, they stay.

And I still believe that if we choose wisely, if we remember what matters, those halls can feel alive again.

Not louder.

Not bigger.

Just fuller.

With people who want to be there.

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