“Begin With the End in Mind”, Stephen Covey

I don’t recall ever hearing about Stephen Covey’s head injury in a bicycle accident in April this year. Despite wearing a helmet, he sustained a brain bleed and died on July 16, 2012, surrounded by his loving and devoted family. I asked a couple of residents what they knew about Covey, and they didn’t recognize his name. I was stunned. His book “The 7 Habits of Highly Effective People” improved the lives of millions of people all over the world [1]. I didn’t encounter the book until my first year of residency in psychiatry at The University of Iowa Hospitals and Clinics (UIHC). I used it as the basis for one of my lectures to the residents during the early part of my career as Chief Resident in my senior year of residency training.

The second principle, “Begin With the End in Mind” is especially relevant for me. There were so many “projects” that I got involved in during my first year as an Assistant Professor in the department after I graduated. In an academic environment, it’s particularly important to distinguish yourself in some area in order to gild your curriculum vitae and buff your path to promotion. At least, I thought it was important. There were so many times when I didn’t think about the goal, didn’t look at the wall on which I hoisted my ladder. I was not poorer for the experience. I learned a great deal. I took the 7 Habits Signature Program about 4 years ago, during a critical time in my career when I was making a decision about whether or not to leave academia. That’s a long story and the bottom line, for now, is that many decisions in life are not final–thank goodness.

Beginning with the end in mind could mean trying to answer the question, “What do I want to be remembered for after I die?” This question becomes a little more pressing with each passing year for me. These days the slope of my life tends to give me more a perspective on my past than my future, because there is not as much left of the latter. I spend more time focusing on the achievements of others, admiring and praising them. This is not necessarily a bad thing to do in academia,although frankly, the environment tends to encourage self-aggrandizement. In fact, sometimes promotion can be viewed as an end in itself.

But I’m a Professor now. Technically speaking, there are no rungs above the level of Professor per se on the ladder in an academic department. But it’s always possible to branch out into leadership positions requiring advanced degrees in business administration and epidemiology.

However, I think the stage of one’s career can change what goals are practical and desirable. And the older one gets the more other-oriented and less self-aggrandizing one can become. Beginning with the end in mind could mean supporting the work of junior colleagues and being a mentor, especially if the goal is to build a department full of creative and energetic researchers, clinicians, and teachers. It can also mean making more time for family.

I have Stephen Covey to thank for much of my effort to begin with the end in mind. He was a teacher and the lessons from his principle-centered life and legacy deserve to be remembered, emulated, and sustained.

1. Covey, S. R. (1989). The seven habits of highly effective people : restoring the character ethic. New York, Simon and Schuster.

Other books by Covey I found inspiring and practical:

Covey, S. R. (2004). The 8th habit : from effectiveness to greatness. New York, Free Press,.

Covey, S. R., A. R. Merrill, et al. (1994). First things first : to live, to love, to learn, to leave a legacy. New York, Simon & Schuster.



  1. Thanks Jim. He inspired me as well and we applied this principle to the organizational setting of running a submarine. Stephen rode when he heard and wrote it up in his 8th Habit — it was the “I intend to….” part. Story of “Begin with the end in mind here” :


    • David, I remember. It was in the chapter, “The Voice of Influence–Be a Trim-Tab.” It was inspiring and thank you for your story.

      Best wishes,

      Jim Amos, MD



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