Tuesday, March 23, 2010

The Reformer

"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order, this lukewarmness arising partly from fear of their adversaries … and partly from the incredulity of mankind, who do not truly believe in anything new until they have had actual experience of it."

– Niccolo Machiavelli, The Prince

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Wednesday, March 17, 2010

Analyzing life’s fears…

In five months I will sit in on my first medical school lecture and officially begin my professional education. This thought is both exhilarating and terrifying. I am excited to take my education to the next level, to apply my scientific background to the art of practicing medicine. I am also terrified at the idea of eventually cutting somebody open, allowing people to put trust in me knowing their lives are in my hands. Can I, with good conscience, cut somebody open and have the confidence that they will actually come out better in the end? At times these thoughts overwhelm my mind, causing me to doubt the reasons I am going into the well-protected field of medicine.
This is not the first time that these types of thoughts have bounced around in my head. When called to learn the Hmong language I often found myself doubting I would ever actually understand what was spoken, or be able to articulate with power what my heart desired to communicate. At Brigham Young University I often doubted my abilities when a subject would come slow to me, or when I would feel the impending doom of an upcoming exam. I feel similar feelings when I think about the future, having a child, and being expected to raise him well. Life is scary and often we measure ourselves as inadequate when standing in front of our challenges.
I would guess everyone feels this way, nobody excluded. Even the heroes of history are human like you and I. I think on the continuum between gifted and maladroit, most of who history has deemed ‘geniuses’ lie somewhere in the middle. I read a book called Outliers by Malcolm Gladwell. Gladwell’s thesis is that the most successful people are not gifted in the sense we usually think, that challenges aren’t somehow less difficult for them. Geniuses, instead, are molded by their environments, chance playing more of a role than God-given talent. Gladwell describes the rule of 10,000 hours. He says that people such as Bill gates or the Beatles all had to practice for at least 10,000 hours in order to reach the status they achieved. Bill Gates had a unique opportunity to get many hours of computer programming experience at a time when even college students studying computer science didn’t have the type of access Bill did. The Beatles played all-day shows for years, getting hours upon hours of stage experience before they finally made it big. While I question whether or not the hour amount can be quantified, I agree with Gladwell that the environments these people created for themselves led to their success. What sets these people apart from others isn’t necessarily talent, but their ability to practice and get valuable experience.
In a book I am currently reading about surgery, Atul Gawande says,

The most important talent may be the talent of practice itself. K Anders Ericsson, a cognitive psychologist and expert on performance, notes that the most important way in which innate factors play a role may be in one’s willingness to engage in sustained training. He’s found, for example, that top performers dislike practicing just as much as others do. (That’s why, for example, athletes and musicians usually quit practicing when they retire.) But for more than others, they have the will to keep at it anyway.
I find these ideas fascinating. In my own experience, I rarely feel that I have any sort of natural advantage over my peers. What has separated me from others is my willingness to work, to study for hours on end, to read books and get involved in activities relevant to my field of interest. At times, I do feel like I understand things better than many of my classmates, but attribute this to my experience reservoir and not to natural ability. While many people go off during the summer and sell security systems I work long hours at a nursing home. While many students use their free time to do anything that isn’t related to school, I follow a reaction’s progress I started in my lab or read a book about evolution and medicine. Another key to success is to expend energies on things that are of the most value. An undergraduate must work, so why not find a job relevant to your field? An avid reader must read, so why not choose books relevant to what you will study this semester in class? By choosing activities of high value, I have learned some valuable lessons in patient care, critical thinking, and have made countless boneheaded mistakes in the process. Experience is what produces greatness. This is the key to my successes in the classroom and the most relevant tool I will bring with me this year as I begin my first year of medical school.
Worthy challenges seem impossible when first confronted. At one time the Hmong language was impossible in my mind, but I just spent the last week in the mountains of Thailand conversing freely with hilltribe people. Everything I have accomplished in my life, from pen tricks and guitar licks to scoring well on the MCAT, is due to the fact that I don’t ever give up. Once you recognize that the impossible can be overcome, you will take on bigger and more intimidating challenges. In this way greatness is accomplished. I believe I will become a great physician someday and will heal many people, but there is much to experience before that day comes.

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