As a former Team USA figure skater with my own Olympic dreams, I couldn’t help but reflect on my own experience as an elite athlete while watching the Winter Olympics this year. With Match Day behind me and medical school graduation approaching, it is also time to dream of the future again.

In March, I matched into orthopedic surgery for residency, and I hope to complete a sports medicine fellowship to round out the six years of training ahead of me. While I am approaching residency with an open mind about my career path, I have also been dreaming of serving as a team physician for elite athletes since before starting medical school. If I could support athletes, especially figure skaters, at a future Olympic Games, that would be the ultimate dream come true.

Having gained perspectives on sports medicine as both an athlete and a medical student, I have contemplated the role of the team physician in the care of elite athletes from both angles. How is the role defined? What is the scope of practice? What medical knowledge is required? What are the unique ethical considerations?

The closer I become to achieving my career goals, the further away I am from my time as an athlete. So, I am writing this letter to my future self, the team physician. Only a few years out of my competitive skating career, I want to document the athlete perspective while it’s fresh in my memory. I have more than 20 years of experience on the ice, six of those on highly competitive synchronized skating teams, and right now, only four years as a medical student. However, when the time comes that I have spent more years wearing a white coat, I don’t want to forget what it was like to be wearing figure skates and a dress instead.

As an athlete, I feared injury. Not the pain or blood, but the consequences. The thought of being taken off the ice terrified me. Just as a surgeon couldn’t bear to lose the motor function in their hands, no athlete wants to be told they can’t do their sport. I never wanted to give my coaches any reason to doubt me. As a synchronized skater on a team of sixteen, it was sometimes uncertain whether I’d be chosen to compete. That feeling of vulnerability is powerful. We were often reminded that we were all “replaceable.” When you are in a training environment that expects perfection, every mistake feels like it could be your last. But mistakes are inevitable. Athletes are humans. Or was I just another body? Under such fragile circumstances, why would I openly admit to a new ache or pain? I had to be strong, fearless, and flawless. Or at least, I had to appear that way.

I was not alone in these feelings. For high level athletes, there is a culture of stigma around injuries; a sprained ankle can feel like a crime, instead of a normal occurrence. This sentiment is sometimes reinforced by those around us. One time, a teammate came off the ice crying after sustaining a knee injury from a hard fall into the boards. I was scolded by our coach for comforting her, and she was told to stop crying unless she was “really hurt.” As a result, many athletes suffer in silence with injuries. The specific reasons may vary, but the common denominator is fear: of judgment, of being seen as weak, of not competing or playing, of being forced to sit out of practice, of letting yourself or others down, or in my experience, of not being treated with empathy. Looking back, there were times as an athlete when I needed an ally in looking out for my well-being, especially when I did not feel empowered to do so on my own.

When compared to physical ability, mental health is more frequently overlooked and undervalued. But sport requires mental training just as much as physical. Being under the constant pressure to perform at your best can be overwhelming. When combined with the numerous sacrifices elite athletes make in their personal and professional lives, pursuing an athletic dream can easily become more stressful than enjoyable. While the highs are high, I remember the lows being filled with guilt, grief, agony, and regret. The psychological demands of being an athlete are intense, and I know many people who have suffered quietly for the sake of preserving their position on the team. Without having a trusted adult to turn to, athletes may end up battling their inner demons on their own for far too long.

Lastly, I want to discuss life after sport. Eventually, every athlete will participate in their final game or competition. As bittersweet and sometimes heart-breaking as this can be, it is also a reason to celebrate not only a fruitful athletic career, but the endless opportunities that lie ahead in the rest of your life. This is why it is crucial to develop and support athletes as whole people outside of their sport. While being an athlete is a part of someone’s identity, it is just that: one part. The transition away from regularly training and competing as an elite athlete is incredibly difficult. Athletes need to be prepared to face the reality that life goes on after their athletic career comes to a close. Not only that, but they need to be reassured that life without intense sport participation can be just as fulfilling, exciting, and worth living.

The identity shift away from being an elite athlete is something that I still struggle with from time to time. However, I am incredibly grateful that I had such a clear path forward by pursuing a career in medicine. If “team physician” becomes another one of my identities in the future, I hope I remember some of these thoughts and feelings I experienced as an athlete. I believe that having the ability to relate to my future patients in such a deep and meaningful way will be my superpower as an orthopedic surgeon. I hope I can be a trusted leader that people can turn to during any time of need. I hope I feel empowered to fiercely advocate for the short and long-term well-being of the athletes I treat. And finally, I hope I care for each patient with an abundance of compassion, kindness, and empathy.

To the future Dr. Sarah Haugh, I hope you make us proud. You got this.

I would like to thank the Bioethics and Professionalism Honors Program and the Neiswanger Institute for Bioethics at Loyola University Chicago for the guidance on developing this project. I would also like to express my sincerest gratitude to my faculty advisor, Dr. Emily Anderson, for her contributions to this piece, as well as her constant encouragement and support in helping me explore my passions for sports and medicine.

Sarah Haugh is a medical student.