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Monday, December 9, 2013

True genius

Things are going well with the practice, but I am being wrung a bit dry. That’s the reason for my dip in writing. I am putting a lot of energy and emotion into the practice, and I don’t have a whole lot left at the end of the day. I have always been one to write out of passion and convictions. I write because I believe what I am writing, and this practice is taking much of that passion and grinding it out of me.

Again, things are actually going well. I’ve finally been able to take a salary from the practice (imagine that!) and have been seeing a steady growth in numbers. Patients from my old practice keep on contacting me to switch back to my care. I think they realize that this practice is not a sign that I have changed, but that I am unwilling to change despite a system that tried to take my focus off of the patient.

Through all of this, I’ve learned some valuable lessons. I think if there is anything I take pride in, it is not what I’ve accomplished (since I’ve not yet built a self-sustaining business), nor is it the attention and acclaim I’ve garnished. The thing that gives me the most pride is the way in which I’ve changed. I realized this as I got through a particularly hard day, one in which I did tasks I usually procrastinate or pretend I don’t have to do. I didn’t good after that day, in fact, I felt pretty tired and blah after gritting my teeth and doing what had to be done. But my reflection on that day was that I just had a very good day. It was good, not because of the positive emotion or good interactions; it was good because I grew stronger.

I was recently listening to a TED talk on a podcast about the subject of “success.” I actually have resisted listening TED talks because they seem to contain a lot of intellectual self-back-patting and are anything but practical. They seem to be the secular version of the “prosperity gospel” that preaches: “Just believe in yourself enough and you can accomplish anything” (substituting “yourself” for the “God” used by the pandering preachers). That may be unfair, but it is common in this venue.

The speaker (winner of the “McArthur Genius Award,” ugh) was talking about what characteristics of people lead to “success” in the real-world, and she (being a “genius”) noted that the students who were at the top of the test-scores were not the ones who were the most successful. She postulated (ingeniously) that the students who were largely successful at school were not called upon to deal with something very important: their failures. This ability, which she labeled as “grit,” is the key to true success.

While I would call this “perseverance” or “resilience,” I see how this is true in my life. The past 12 months has given me a whole lot of chances to fail, and a lot of cause for self-doubt. I recently was turned down for a small business loan (apparently you need to have enough money for them to justify loaning you money). Being turned down felt a lot like someone had called my kid ugly. What do you mean my idea is not so compelling that you want to throw money at me? What do you mean that you don’t think I’ve got what it takes to make this succeed? Yet in my heart I was wondering those same things. This is hard, and no amount of good ideas and hard work will alone lead to success of this project. I do think it will succeed, but I am by no means confident of that fact.

No, it is not the clever who inherit the earth. It is not those who win “genius awards” (OK, I admit I am a bit jealous) who change everything. True success takes the long road through failure, learning to use the lessons of what doesn’t work, what causes pain, and what our own weaknesses are, to give a much more solid kind of success. It is through endurance of troubles and personal failures, not their avoidance that true strength comes. At that point, it doesn’t matter how many people are telling me I have good ideas or that they think I will succeed. All that matters is that I can now stare failure in the eye and see it for what it is: a chance to grow stronger.

No, I’m not dumb enough to want things to remain this difficult. If anyone wants to throw money at me, I’d be happy to oblige that desire. Endurance, by definition, is not fun, and I hope things ease up soon. But after I was turned down for the loan I got advice from the wisest person I know: my father. He told me to not get too down about this, to not react right away, but to wait and see what God was doing in this. He told me of the times when things seemed the bleakest for him and how he was tempted to shake his fist at the heavens, but that after enduring the pain and seeing things in perspective, how he concluded that this was for the best.

That’s wisdom. That’s true genius. Endure, don’t avoid. Embrace failure to succeed.

Thanks, Dad.

Gotta go. There’s work to do.

After taking a year-long hiatus from blogging, Rob Lamberts, MD, ACP Member, returned with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind), where this post originally appeared.

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Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.

Auscultation
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

Controversies in Hospital Infection Prevention
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, FACP, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

Peter A. Lipson, MD
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.

World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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