SUO 2023: Joseph A. Smith, Jr. Mentorship Award Lecture: Take Inventory, Embrace Failure, Move Forward, and Be Grateful

( The 2023 Society of Urologic Oncology (SUO) annual meeting held in Washington, D.C. between November 28th and December 1st, 2023, was host to the annual Joseph A. Smith, Jr. Mentorship Award Lecture delivered this year by the awardee Dr. Robert Uzzo, entitled: “Take Inventory, Embrace Failure, Move Forward, and Be Grateful.”

Dr. Uzzo began by humbly acknowledging the committee for bestowing this prestigious award upon him – “If I have seen further, it is by standing upon the shoulders of giants.” – Sir Isaac Newton. Staying true to this quote, Dr. Uzzo acknowledged the individual after whom this award has been named: Dr. Joseph A. Smith, Jr.

Dr. Uzzo fantastically summarized Dr. Smith’s journey, highlighting events and people/mentors who shaped his career. Dr. Smith was enrolled as a Reserve Officers' Training Corps engineer at Notre Dame, with the aspirations of becoming an astronaut. Unfortunately, his father passed away suddenly as a freshman. At that time, he did not know any doctors and was unimpressed by the hospital and doctors. To honor his father’s memory, he decided to become a doctor and do better. He forfeited his scholarship and moved closer to his mother and six siblings in Tennessee. He attended medical school at an early age and worked during that time between 11 pm and 7 am starting IVs in the hospital wards. He next moved to UT Southwestern where he had the privilege of working with Dr. Peters – "Dr. Peters made operations look so hard it inspired me to go into Urology…He kept non-stop pressure on the residents. I loved the residents and their enthusiasm for the specialty".

Next, Dr. Smith’s journey took him to Utah where he sought out Dr. Dick Middleton, an impressive young chair at the time – “"Something about him made me think this was the person under whose influence I wanted to train…one of the most generous, honest, unassuming and caring individuals I have ever known...and he was a terrific teacher…I developed a universal admiration and fondness for my mentors.”

Next, Dr. Smith went to Memorial Sloan Kettering to train with Dr. Willet Whitmore – “I remember hearing Dr. Willet Whitmore talk about training 'cutting surgeons' - I wanted to be one of those".

Finally, Dr. Smith returned to Tennessee where he joined Vanderbilt University and served as chair for a long time – “I had a sense that we could create something very special at Vanderbilt." During that time, he mentored dozens of faculty members, hundreds of residents, and fellows, and authored thousands of abstracts, publications, chapters, lectures, and conducted numerous trials. He served as the editor of The Journal of Urology, chaired the urology residency review committee, and was the president of the American Board of Urology. Among his many honors, he was awarded the prestigious Hugh Hampton Young Award for his services to the field. But his efforts and achievements have not been restricted to advancing the field of urology – he served 21 years as a physician in Yellowstone, completed dozens of medical missions, and has helped thousands of patients across the globe as well as tens of thousands of families.

But how does one become a good mentor? Obviously, there is no one answer to this question. But from Dr. Uzzo’s experience, the first step is to take inventory of one’s self:
• Care Teacher - instruct, guide, mentor
• Care Advocate - build, influence, improve
• Care Administrator - grow, manage, lead
• Care Discoverer - research, publish, innovate
• Care Deliverer - treat, heal, comfort

Dr. Uzzo highlighted his mentors along the way who served as his care teachers. He, in particular, highlighted Dr. Indebir Gill who has been instrumental in advancing the field of urology. While Dr. Uzzo had a firsthand experience of what it takes to be a great mentor, he asked himself: “How can I be like them?”.

What about care leadership, care advocacy, and mentorship? While many urologists along his journey, including Drs. Eric Klein and Marston Linehan, served as excellent care advocates and administrators, he sought out the expertise of people outside the field of medicine, including Ken Blanchard and Spencer Johnson who have provided him with a global, ‘higher’ perspective, along with indispensable pearls along the way.

How does one take inventory of one’s self as a mentor? A mentor’s role includes being:
- A coach, advisor, and guide
- A listener, supporter, and confidante
- A resource person
- A champion and cheerleader
- A strategist
- A role model
- A sounding board
- Managing lifestyles and image makeovers

But what kind of mentor are you? There are many different pyramidal roles, as proposed by Shawn Blanchard (in hierarchical order):
- Informal mentor (passive)
- Formal mentor (active)
- Example (role model)
- Director (role model “+”)
- Sponsor

After taking inventory, the second step involves embracing failure. Unfortunately, the system does not prepare us well to embrace, accept, and grow from failure. Growth is not linear, and in this setting relies on practices, processes, and people (Patrick Boland).

After embracing failure, the next step involves moving forward and finding a mentor. There are many types of mentors, as described by Doug Stewart:
- Categorical: People with best practices to repeat
- Anti-mentor: People who show us what not to do
- World view: People who are better able to see the bigger picture than you are
- Street view: People who stand with you and keep you on track
- Time machine: People from your past or historical figures
- Stealth: People you did not realize are mentoring you

The final step is being grateful. One must reflect and see themselves as a victor, not a victim. While it may not always be easy, one should deliberately notice the good things in life and avoid the common pitfalls. Formalize your gratitude – write three good things daily. Importantly, build a culture of gratitude:
- Make it part of your personal brand
- Write thank you notes and emails
- Seek to call out those who go unnoticed
- Thank patients for their trust in your team
- Teach gratitude

Dr. Joseph Simone, a legendary figurehead of St Jude’s Pediatric Hospital in Memphis, TN, emphasized that:
- Leadership matters: Leaders articulate a consistent, simple, and public vision
- First class people recruit first class people: Personal attitude and team compatibility are grossly underrated in recruitment
- Resist temptations to compromise your integrity

Going back to Dr. Smith’s legendary journey, unfortunately, rarely are such journeys void of low points. Dr. Smith lost his long-term partner, Barbara Bradford Smith, in September 2020. True to character, in lieu of flowers, Dr. Smith and his family requested that donations be sent Thistle Farms in Nashville, TN. Thistle Farms is a community of individuals helping women survivors overcome and heal from systems of prostitution and exploitation. Communities such as these are the ’oldest form of healing in the world’. Why should institutions and the group of individuals in such teams be any different?

In essence, this talk could be summarized with this quote by the legendary George Bernard Shaw: “Imitation is not just the sincerest form of flattery - it's the sincerest form of learning”.

Presented by: Robert G. Uzzo, MD, MBA, FACS, President and Chief Executive Officer, Fox Chase Cancer Center, Temple University Health, Philadelphia, PA

Written by: Rashid K. Sayyid, MD, MSc – Society of Urologic Oncology (SUO) Clinical Fellow at The University of Toronto, @rksayyid on Twitter during the 2023 Society of Urologic Oncology (SUO) annual meeting held in Washington, D.C. between November 28th and December 1st, 2023

  1. Smith Jr JA. Legends in Urology. Can J Urol. 2015;22(1).