The Laws of Nature Abides No California Stops

A patient the other day asked me at the end of her visit what I liked best about being a doctor. The question caught me off guard, mostly because we were talking about mother-in-law dynamics and how she was glad to have a good relationship with her daughter's husband. I said something about a mandate for life-long learning and building relationships, whatever. Yeah, that is all true. But I've been slowly grinding on that question for a few days and on a day off may have identified, specifically what I like best.

Last week I went to a drug rep dinner (maybe the best one I've been to, with a charismatic speaker and valuable information no less) but, no, while as a resident these dinners are appreciated, they are not my favorite aspect of being a doctor.

The trust that people have in me, is something that I never take lightly and while I couldn't be a physician without this dynamic I couldn't do that as well without the doing this -- Active Self-Criticism.

I'm not criticising myself to make myself feel bad (sometimes it feels bad) but to change my behavior and grow my "toolbox" in order to be a better physician -- with increasing ability to develop my judgement and efficiency in managing interventions, medications, evaluations, and communication with patients -- with an emphasis on effective two way communication.

This is a difficult thing to do, it is tiring. In medicine we are taught, in class and ultimately by taking care of patients, that "anchoring" is dangerou and needs to be actively guarded against. Very simply, anchoring is latching onto an initial diagnosis or impression despite new or changing data that indicates otherwise. On a complete side-note, I go back and forth on my feelings of using italics, or (God forbid) all caps to emphasize any point I try to make. I rarely send text messages with more than one exclamation point or question mark in a row -- if more equates to stronger sentiments, where does it end?


Just as Bobby Digital, amongst many other luminaries are fond of saying, I try to adhere to the "word is bond, yo" philosophy, and as such, why should an italicized word mean more than the letters of increased verticality? But, then I must contemplate and meditate on the fact that my speech is not of all the same quality and that by the mere way I say words can add to, if not completely supplant the words and the meanings they traditionally hold. A life of conscious duality isn't too bad.

Back to anchoring -- this isn't unique to medicine, this is obvious. The essence of anchoring is choosing the path of least resistance even if the path is a dead end. It is lazy and mandates instant gratification or satisfaction over truth and ultimately, experiencing the best outcome of any given setting, situation or problem. We do this in our lives in so many ways; perhaps our self-image hasn't kept up with the actual shape our bodies are in. Maybe a relationship that has been neglected is still viewed through the lens of years ago. See, we hold on to old data because it helps us build a reality that is emotionally pampering versus the truth, that reality will not allow for what would have been the best outcome.

I saw the clip of Rush Limbaugh saying that Irma, and hurricanes in general were welcomed and capitalized upon by the liberal democrats who desired to advance an agenda based on climate change and the repercussions thereof. But, no -- wait, he did not say the 'repercussions thereof' -- he just left it at "agenda of climate change." This of course is so completely disingenuous -- and I hope all of you can see this. BUT, why not extend this fallacy to see how it holds up. What if climate change is a hoax? An evil agenda to -- to, uh, reduce the power of the oil industry which is nearly indistinguishable from the industrial-military complex? An evil agenda to decrease risk to a fundamental vulnerability to live, produce or defend ourselves in the setting of even a minor production wane? An evil agenda to transfer jobs from coal mines, which destroy lives and mountains to jobs manufacturing windmills and solar power products? An evil agenda to clean up the air and reduce particulate pollution in the city so my wife can breath without an inhaler? An evil agenda to have roofs made of solar panels that can store energy in batteries in the garage and sell power to the grid when the need is high. The people who want these things, these hippy, libtard, overeducated, safespace-needing, common-sense lacking cucks are taking us to a dark world indeed. Anyway, Rush ended up evacuating after all.

While Mr Limbaugh may not necessarily actually believe the things he says, especially knowing that drama and controversy brings listeners. But on some level he is being dishonest with himself. If he does believe the things he says, he definitely is lacking in active self-criticism. If he does not, he is using deception to advance a political agenda and this is profitable for him. It is one or the other. He has the luxury of sitting back and not being held accountable for lies, or misinformation that may harm individuals or the country as a whole. He is immune in that capacity, legally speaking,  however if you believe in a God or higher power, or whatever, this kind of individual is asking for trouble when it comes to accounting for their actions and life's work. But most of us, to some degree or another, do not have this luxury. That is, we are held accountable for what we say and do at work and in our lives, in general. A shitty carpet installer won't have a job for long. A careless doctor may find themselves in deep doodoo. A doctor that intentionally deceives people may go to prison.

This dynamic of professional development can, if one desires, spill over into other aspects of life. Especially as doctors advance in their profession and the fundamental foundation of competently managing their patient population, we can obsess over other professional endeavors and, of course, hobbies can become all consuming, as well. I write all this at the risk of sounding like a self-righteous self-help peddler of propaganda. But this lesson is something that can be applied in every one of our lives. Whatever you are doing during the day, endeavor to do it well. Maybe all you are going to do is lay in bed and watch Rick and Morty, old Simpsons seasons and maybe a Ken Burns documentary with the most active aspect of the day being doing laundry. Do the laundry well. Get. Those. Stains. Out. Make sure the dryer vent isn't clogged. Remember to check the lint filter.

And it is this component -- that I must always evaluate my performance and prepare to improve forever and ever amen, that I most like about being a doctor.

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