Pivot: Lessons in Adaptation from Life and Medicine

The following is adapted from Clip Toenails for a Living by Marcin N. Vaclaw.

Life rarely goes according to plan. Early lessons in pivoting came during my time at Brigham Young University. My first organic chemistry class was massive—hundreds of students, a few TAs, and complex concepts. One day, frustrated with my grades, I met the professor. Without looking up, he asked, “Are you a powerboat or a sailboat?” Confused, I replied, “Uh, I don’t know.” He said simply, “You need to be a powerboat.”

I realized he was teaching me about drive and ambition. A powerboat powers through adversity, while a sailboat adapts to circumstances. Over the years, I’d come to see the value in both approaches: ambition and adaptability, improvising when the wind shifts.

The most profound pivot came from my sister, Katie, born with Prader–Willi syndrome, a condition that left her perpetually hungry and at risk of serious health complications. Our family had to improvise constantly—locking cabinets, creating systems, and learning patience and adaptability. Eventually, she moved into 24-hour supervised care, giving her a safe environment and teaching our family the importance of adjusting to life’s circumstances while pursuing long-term success.

Life tested me again in college when I planned to follow my father into dentistry. A saturated market and competitive admissions made me question my path. A friend suggested podiatry—a field I had barely considered but one with high demand. Pivoting to podiatry required adaptation, quick learning, and a willingness to embrace a new course.

Residency brought further lessons. “Match Day” was chaotic, with limited positions and high stakes. After a disappointing start, I scrambled to secure a residency in Houston, calling programs and networking, ultimately landing a position that aligned with my personal and professional goals. There, I discovered a crucial insight: the most important care often isn’t the most glamorous. While surgeries were celebrated, day-to-day patient care—like clipping toenails—was essential. Focusing on these fundamentals while managing a business became the foundation of my practice.

Opening my own clinic required yet another pivot. I had to choose location wisely, considering patient flow and competition. By situating my practice in the Woodlands, I embraced a competitive environment that forced me to improve while ensuring growth opportunities.

Throughout these experiences, I learned to be flexible—a chameleon, as a co-resident put it. Adapting to circumstances, reading the room, and adjusting strategies have been central to success. Whether tackling personal challenges, career shifts, or running a business, the ability to pivot—without losing sight of your goal—remains the most valuable skill.

Life will throw curveballs. You can either resist or adjust. Pivot. Adapt. Overcome. Harness the circumstances around you like a sailboat harnesses the wind, and you’ll find your path forward.

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For more insights on how to pivot and thrive in your career, you can find Clip Toenails for a Living on Amazon.

Marcin N. Vaclaw, DPM, is a founding partner, chief medical officer, and executive chair of the medical advisory board for a nationwide podiatry conglomerate. After securing a small business loan, Dr. Vaclaw turned a single clinic-based and in-home-supported model into a multimillion-dollar national podiatry platform. His company is now one of the largest podiatry groups in the United States. A native Oklahoman, Dr. Vaclaw lives outside Houston, Texas, with his wife and their six children. In his additional ventures, Heavenly Cattle Co. and Timber Grove Equestrian Center, he and his wife breed miniature Highland cows and offer board, training, lessons, and breeding for horses.