It's not only the stakes but also the complexity of performance in medicine that makes it so interesting and, at the same time, so unsettling.
We must grapple with systems, resources, circumstances, people - and our own shortcomings, as well.
Three core requirements for success in medicine - or in any endeavor that involves risk and responsiblitiy.
1. diligence, the necessity of giving sufficient attention to detail to avoid error and prevail against obstacles. Diligence is both central to performance and fiendishly hard.
2. To do right. Medicine is forever troubled by human failings, failings like avarice, arrogance, insecurity, misunderstanding.
3. ingenuity - thinking anew. It demands more than anything a willingness to recognize failure, to not paper over the cracks, and to change. It arises from deliberate, even obsessive, reflection on failure and a constant searching for new solutions.
Suggestions for Becoming a Positive Deviant
1. Ask an unscripted question. If you ask a question, the machine begins to feel less like a machine.
2. Don't complain. You don't have to be sunny about everything. Just be prepared with something else to discuss: an idea you read about, an interesting problem you came across, even the weather if that's all you've got.
3. Count Something. If you count something you find interesting, you will learn something interesting.
4. Write something. What you write need not achieve perfection. It need only add some small observation about your world. For all its complexity, medicine is more physically than intellectually taxing. Because medicine is a retail enterprise, because doctors provide their services to one person after another, it can be a grind. You can lose your larger sense of purpose. But writing lets you step back and think through a problem. Even the angriest rant forces the writer to achieve a degreee of thoughtfulness.
5. Change. Individuals responde to new ideas in one of three ways. A few become early adopters, as the business types call them. Most become late adopters. And some reamian persistent skeptics who never stop resisting. Nonetheless, make yourself and early adopter. Look for the opportunity to change. I am not saying you should embrace every new trend that comes along. But be willing to recognize the inadequacies in what you do and to seek out solutions. As successful as medicine is, it remains replete with uncertainties and failure. This is what makes it human, at times painful, and also so worthwhille.
So find something new to try, something to change. Count how often you succeed and how often you fail. Write about it. Ask people what they think. See if you can keep the conversation going.