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There is a tendency in writing about oneself to accentuate the positive.

This is probably extends from the way that we see the world. From one perspective. Through one set of eyes.

We are the protagonists of our own novels so we want to be likable, (most of all to ourselves.)

But every story has ups and downs, challenges and drama. And my story is no different.

To say that I am imperfect, is a massive understatement. This is not a newsflash, of course. But actually writing about my failings is not something that I ever really want to do.

But what good is a philosophy without conflict? And how is positive change even possible without first acknowledging flaws that need addressing?

So allow me to lie down on this Austrian couch, or kneel in this Roman catholic confessional, there’s a scab that needs a little debridement.

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 Allow me to assume the position

 I often write about the parts of my job that I love. Like talking to my patients about their lives, or mapping out complex arrhythmias, and getting rid of them.

But there are also parts of my job that I don’t like. Like meetings, and paperwork, and complications.

But the big one, and this is not specific to being a doctor, is the busywork.

And this has been true for long as I can remember. When there was an assignment in elementary school that was interesting I could dive right in and excel, but if the assignment was not immediately interesting to me, I had great difficulty applying myself to it and just getting through it while still doing a good job.

The problem, though, is that in medicine, sometimes busywork is really important.

Although it is easy for me to take extra time in the lab mapping an arrhythmia, or in a patient’s room talking to them one-on-one, (because I enjoy it) it is very difficult for me to bring myself to attack the in basket on my computer that contains patient call after patient call stacked up upon one another.

I have always dealt with this by just saving my patient calls until the end of the day and plowing through them before going home. But this is dry and boring work. And I feel disconnected from my patients.

Because I am not in the room with them, their problems are not as real to me as they are, in fact, in real life.

There is also a signal-to-noise problem. Amongst all the questions about prescription refills and small aches and pains, there might be a big problem masquerading as a small one. And it takes effort and attention to detail to ferret this out.

But mostly it’s just my own damn laziness.

The nub of it all is that I’ve noticed that I can deliver poor patient care /customer service when addressing my patients real problems that present in this particular way.

This is deeply disturbing, and is in stark contrast with the way I would like to see myself as a doctor and as a professional and as a person.

Honestly admitting my own failing is important, and is a necessary first step to getting better at this. But it’s just the first step.

And be honest I don’t really have a second step at this point.

Just saying I’ll be more conscious of my phone notes is unlikely to bring about change. (To me this seems analogous to saying I’ll just eat smaller portions from now on to lose weight. )

I will need to experiment with different approaches until I find one that works for me.

I don’t think answering phone notes will ever be fun, but perhaps I can find an adjustment that makes telephone triage feel as important has it actually is.

The analogy here, of course, is to personal-finance.

Maybe you have a spending problem.

Maybe you have too much credit card debt.

Perhaps you have a personality quality that makes it difficult for you to do the right thing when it comes to making smart financial decisions.

Are you ready to admit that you’re flawed?

Are you ready to put in the hard work of experimenting with different approaches, until you find one that works for you?

It ain’t fun. But it’s probably important.

Would you care to sit down on this Freudian couch?

The cushions are soft, and you know what? I’ve warmed them up for you.

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2 Responses to “inconsistencies”

  1. Robert February 13, 2014 at 6:29 am #

    Sometimes “flaws” are just the unique expressions of our personality type; people with other personality types thrive on what we detest, and vice versa. It can sometimes be helpful to view things not as guilt-inducing flaws, but as personal characteristics that are unlikely to change but which you can creatively manage. One of my favorite ways is to find someone of a complementary personality type and offload the tasks to them! :-)

    I like the Myers-Briggs personality type analysis. You sound like you may be an NT (just a wild guess; not so easy to determine from a few blog posts). NTs thrive on new and different. Sometimes SJ types thrive on the routine and doing the behind-the-scenes hard work that it takes to bring an NTs creative idea into reality. Find yourself a partner! (Of course, the flip side is that NTs and SJs can have lots of conflict).

  2. Miles Dividend M.D. February 13, 2014 at 7:42 pm #


    That’s an interesting take. I don’t know how racked with guilt I am. But I do know that when I feel I’m not doing my best at my job, it makes me feel unhappy.

    I like the idea of offloading the aspects of my job that I don’t like onto a complementary team member, but I also like the idea of self sufficiency.

    My focus of late has been to harness the power of play to move me towards worthwhile goals and towards positive changes in my behavior. In a sense I am trying to trick myself into doing things that I don’t intuitively want to do.

    This “busywork” is a puzzle that needs solving and I’m still searching for an angle. But I feel it’s a worthwhile puzzle to work on at this time.


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