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Begin with the end in mind, and with the courage to face it
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The late Stephen Covey asserted in his classic book, The 7 Habits of Highly Effective People, that we all do well to begin with the end in mind. That is, any important life or career goal is staged most successfully by first creating a clear vision of the outcome we desire.
Once we have completed this mental and emotional exercise, we have an endpoint on the horizon, toward which we direct our steps, plan our strategies and make all key decisions accordingly. It is simply what highly effective people do in accomplishing great goals, overcoming serious obstacles, and otherwise planning for success and fulfillment in life and work.
Craig N. Piso
However, there is a catch: To begin with the end in mind is to accept that all good things must end. And although this is especially difficult for surgeons to consider that the careers for which they prepared and paid such high tolls will to come to an end, it is even more difficult to consider that our quality of life, and life itself, gradually declines and also comes to an end, with or without a plan. Therefore, it takes tremendous courage to remove the emotional obstacles standing in the way of long-term planning: fear of loss, fear of decline, fear of irrelevance, fear of failing health and loss of functionality, and ultimately fear of death.
Accordingly, those who muster the courage to confront these emotional obstacles and complete the necessary work of acceptance gain a certain humility and emotional security that enable them to then commit to strategic planning, both for their life and career goals, long term. Ironically, embracing, rather than avoiding, these facts of living and working tends to liberate us to make reality-based choices in the short term that support our mature perspective regarding the long term. Courage is certainly not being unafraid; it is simply moving forward effectively in the presence of anxiety and doubt. Courageously plan your work and work your plan.