Monday, December 9, 2013
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.
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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Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:
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.
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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.
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, 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
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).
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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.
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.
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.
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.
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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.
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.
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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.
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.
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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.
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