Good Job

"You lack interest", she said. And then, a miraculous force ripped my chest open and poured a bucket of ice at the surface of my heart, numbing everything completely. A single tear forced itself down my cheek rather slowly.
I quickly looked down to hide it, pretending to be interested in the notes I took that afternoon.
I was able to suck it up gracefully, smile, and go through the case. I think it went quite awfully, but at least, i gave myself credit for not crying in public.

I probably cried because this was not the first time I had heard something like that from the same person. I have endured "How do you not know?" and "You really don't know something that basic?!" and similar other comments. But once my interest was judged, the trigger was pulled. And I watched as my self-esteem went down the drain. I have so much passion for what I do and I could not handle someone undermining it.

During my ride back home, the self criticizing voice in my head did not stop nagging. And I could not blame it. I mean really! How could you not show it, self?

99% of the time, I end my conversations with myself taking the blame. I am guilty by default, unless I have sound evidence to counter my self-critical inner voice. So in that particular situation, with not enough evidence to present, I complied to the fact that I was wrong. I then proceeded with my dramatic rituals which I will not go into details as my emotional turmoil is not that interesting anyways. But, to make it short, I tend to me over-sensitive at times.
Some say I was being too self critical and unforgiving. I like to say I was being responsible.

So, after taking complete responsibility for not showing interest, I tripled my efforts. I went above and beyond not only to learn but also to adopt a good and accountable attitude.
I became better afterwards. In the end, I did a good job.
Sounds good?
I didn't think so.
You see, I'm not a fan of "good jobs". I like great jobs! excellent jobs! out of the ordinary- magnificinat jobs!
I understand that the effort I put in does not equal the results I see. I'm fairly ok with the fact that I can do a whole lot of effort and get an "OK" job done, but that is what will drive me to do better. I also believe that all the effort will sum up to something later. It's not necessary to see instant results as long as I'm getting at least a little bit better everyday.

For that, I am thankful for the person that criticized my interest. I know for a fact that I did not lack interest at that time, or at any other time for that matter. But for whatever reason, she didn't see it and voiced it out in what i think was a bit mean. But really, who cares? The end result is: It made me better. That's why I'd rather be criticized and hurt than be told "good job". Had she said: 'good job' instead, I might have continued with my routine without having a drive to be better.
Pain is a drive. It's a very powerful one, too.

I still cannot decide weather or not inflicting pain into a person in order to make them better is ok or not. I can decide however, that I do not want to do it to others in the future. But, the fact that it has made me so much better in so many ways, makes me slow down before judging those who use this method. 

Ten Thousand Hours

I've never idealized a number until Malcolm Gladwell mentioned "Ten thousand hours" in his book: The Outliers.

Psychologists have a way of keeping their debates alive for decades. One of those is the ever lasting debate of "Are experts born or made?"
In the 1800s, it was proposed that experts were born regardless of the amount of practice or effort put by the person. An innate characteristic exists in every person that defines his or her level of expertise. In fact, Sir Galton published a book called Hereditary Genius, in which he states: "I propose to show in this book that a man's natural abilities are derived by inheritance, under exactly the same limitations as are the form and physical features of the whole organic world".

Others later on challenged that proposal by performing studies on elite performers weather in sports or music and correlating the hours of practice with level of expertise.
Gladwell describes many such examples and then states: “The emerging picture from such studies is that ten thousand hours of practice is required to achieve the level of mastery associated with being a world-class expert—in anything,” writes the neurologist Daniel Levitin. — p. 40.

To make things complicated, our psychologist friends were still trying to keep the debate alive. So again came another group who proposed that: Yes, practice is essential, but how much practice you need is genetically determined. They backed up their theory with twin studies in which they found that if a twin can draw, the other one is more likely to know how to draw as well. That's pretty sound evidence. But let's not go there. Let's go back to practice.
I'm not trying to undermine your genes. But let's face it. Unless you're God, you cannot control your genes. Hence, life becomes much more fun and simple when you focus on the things that you can control. And we like fun and simple. So, let's be in the driver's seat of our expertise and control our practice. 

Regardless of the number (because I learned that it's not that important anyways), notice that when Gladwell talked about practice, he said 10,000 hours not 10,000 pages. The studies were performed on musicians, sports players, chess players, computer programmers, and many more. Still, the common thing between them was 10,000 hours of deliberate practice: 10,000 hours of playing the violin, 10,000 hours of playing chess, or 10,000 hours of computer programming. It was never about reading, because apparently no amount of reading can produce an expert. Accumulating data, is essential for building a base. Going up the ladder, on the other hand, requires more effort. It's easy to agree that you have to deliberately  and consciously practice. It's harder to apply it.  The opportunity will not come to you. You have to go to it. Often times, you will go to "Mr. Opportunity" and find yourself standing behind a locked door that won't open. But depending on how bad you want it, you will stand. You will endure. And in the end, it will crack open. And when it does, and you see only a glimpse of light, you might get discouraged because you expected more right? A rainbow maybe? Oh well, It's hard and dark. It's a mess and it's a lot of sweat. But at least, it's not painstakingly average. So, keep going on because you're on the right track.

I can tell you for a fact, that the 'ten thousand hour'- rule is applicable wherever you plug it in. For example, in my case, as a budding radiologist, you need X hours of practice. And by practice, I mean cases.
During your first year of radiology, you find yourself in a very steep learning curve. I guess it's only natural, given the almost vertical slope, to feel like you're barely hanging in there. But still, that doesn't put you off the hook of collecting cases from day one. Within the past year, I've observed a humongous difference between those who read more and those who take cases AND read as well. If you were a book worm at med school, like me, you'd understand that shifting your ways of  learning might be frustrating at first. But flexibility with your approach and the trial and error method are always helpful. Keep trying until you find your balance and once you're there your "learning endorphins" will kick in. It's a natural high!

Bottom line, read a lot but remember that what separates the good from the great is that the greats practice more.

Uphill

I finished at 9 pm on Thursday. Was I tired? No. I was exhausted! I was mentally drained and internally frustrated by my lack of knowledge and slow pace. Nevertheless, I had a combination of feelings that were in the middle between punching someone in the face and patting myself on the back. I felt like an old lady who finished last on a marathon but was still happy that, despite her age and poor physical conditioning, was able to cross the line after sunset.

I happen to be a person who's very sensitive to criticism, but I try my best to channel the negative energy that comes out of it into proving to myself that I'm better than that. So, after being discouraged by my lack of knowledge and experience in body CT, I channeled that discouragement into doing more of it. After two days, just two days I was overwhelmed. But still, it's a bittersweet overwhelming feeling, because I know deep down, that it's for my own good and it will build a better me on a personal and professional level. 

On the other hand, I have also been criticized for putting too much effort, and for being too hard on myself. I've been told that I will regret this. But I keep imagining myself ten years from now, and all I can see is anything BUT regret. I often question if they're right, but how I feel after a long tiring but productive day, always proves them wrong. When you're driven by passion and purpose, nothing can stop you. I mean it's not like you can say: 'Hey there passion and purpose, please slow down, I got other things to do'. Things just happen, and you find yourself poring gallons of time and effort into the thing you love the most. So no matter how much people will dislike my crazy efforts and random, yet constructed desicions, I don't think right now is a time to change them.

The thing is, that during your first year of radiology, or any other new specialty for that matter, you find yourself in a very steep learning curve to the point that you'd think it's almost a vertical line. Unluckily for you is that, the rules of physics are not in your favor; It's very easy to fall down climbing up a hill with a slope of infinity. Can you imagine the amount of effort you'd need to climb up a vertical wall, fall down a thousand times, and climb up a thousand and one times. Effort right here is equal to infinity too then. It's not just the effort though; it's being immune to discouragement, because at times, you will feel belittled, discouraged and useless. The good news is: the farther down the road you get, the easier it becomes, and the more naturally it comes (or at least that's what they say). You just have to endure the first few steps outside of your comfort zone, and then you'll be free: free to be great at last! ;)

Not so Comfortable, Eh?

"Are you comfortable?", my aunt's friend asked me.
After a moment of silence, I replied with a hesitant  "Yes".
I was 6 years old at that time, and I was always praised for my good English back then. So, it was expected of me, that my range of vocabulary would go beyond that of a little kid who speaks English as a second language. Nevertheless, I had no clue what "comfortable" meant. I tried to spell it in my head, and I broke it down to syllables with no luck.
We were crowded in a small car, so I was sitting on my aunt's friend's lap. She was sitting on the edge of her seat and I was sitting on the edge of her lap, with the front seat pressing against my knees. My legs had no room whatsoever and my knees kept bumping into each other with every turn. One of my feet was trapped between her foot and the front seat. The other one hung loosely at a very awkward angle making it pretty painful. It was supposed to be a half an hour ride, and as you can tell, I was very, very far away from being comfortable.
I did not want to swallow my pride and ask "what does comfortable mean?" but she noticed that I was seated very awkwardly so she kept asking the question of "Are you comfortable?" over and over again. and I replied with a safe "Yes" every time. Near the middle of our ride she told my aunt, "Look at how uncomfortable she looks. Her legs are so stuck together. Maybe she doesn't know what comfortable means." As if I was not just sitting there. My aunt replied, "Of course she knows what it means. It's Ruru!" Like it's only natural for me to know things. I was very proud at that moment. I would never let anything compromise that image she had of me. So I inferred from my aunt's friend's sentence that "comfortable" has to do with my position. So I told my self that next time she asks the question, I'll say "no" and see what happens. Unluckily for me, she never asked again. And I tolerated the pain until we reached our destination. Later that night, I ran into my room and opened up the dictionary to the word "comfortable" and there it was. At the end of the day, I was an arrogant kid with very painful knees but still learned the word: comfortable.
Ironically, It took me 20 years to find out that how I acted was completely wrong. Throughout my medical education, I made sure to go above and beyond what's expected so as not to put myself in a position where I have to say: "I don't know". I firmly believed that if you work hard enough and used your time wisely and efficiently, you will minimize your "I don't know" moments to a level that will make them go unnoticeable. As a student, this worked out pretty fine. Later on however, what's expected became so overwhelming that I couldn't catch up. I could not maintain my "one step ahead of everything" stance. And not admitting my ignorance was no longer painful for my knees. It was painful for my patients. Once a third party is added to the situation- and we are not talking about any third party, we are talking, the person you are supposed to "take care of"- It does not matter how much it hurts not to know. Your image is not even remotely important. And what's important is what's at stake. What's important is your patient and only your patient. Because from a single experience, your patient's pain exceeds by far, your pain of not knowing. In that setting, it's your duty and the patient's right as well to admit your ignorance and ask for help. It is not acceptable by no means, to put your fear in front of your patient's best interest. Stepping down is often not only the right thing to do, but the safe thing to do. Regardless, stepping down should be accompanied by your efforts to go up. If you keep stepping back without doubling your effort to go up, you'll stay stagnant. And from my point of view, stagnation is as bad as going downhill. So aim high -the highest you can- while still accepting the fact that there will be times where you will come short. As a wise man said: "Inflate your ambition, and deflate your ego".

Heart Work

Life has taught me, over and over again, that success is the result of hard work. The contribution of other factors, such as luck, is close to zero which is why it is often dismissed in the equation of success: hard work = success. And, like any other mathematical equation, it's only logical to say that increasing the amount of the variable on the left side will, with no doubt, magnify the amount on the right by the same value and vice versa.
But don't we all know a few people that work hard and never succeed? Don't we all know someone that works day and night and gets minimal results? The above relationship is clearly not linear and there has to be something else that we're missing in this equation.

During the past month, I have witnessed the success of a handful of my friends. I can assure you, they are all pretty hard working. But I don't think that this was their secret. What makes people stand out is not their hard work. What makes people stand out is there heart work. How much 'heart' are you willing to put into your next project? your next goal? your next plan?
Are you really passionate about what you're doing? Do you really believe?  Putting your heart out there is quite risky. You might feel exposed and at times, vulnerable. It gets overwhelming and any change of events can trigger a gush of emotions traveling with the speed of light throughout your soul. Not to mention that it requires a certain level of maturity and self control so as not to let your heart mess with your judgement. Nevertheless, you're a human being with mental capacities that should be in the driver's seat of your work.

But still...adding the heart dimension to your work gives it so much depth and value. Not only that, but that same force driving you to the right side of the equation is the same energy source that you need to keep going. It's the fuel that feeds boldness, persistence, and perseverance.
But wait, there's more..
Heart work is vibrant. It's infectious. It's self regenerating. It is probably the only source of energy that defies the rules of physics and can in fact be created by no one other than yourself. And when it transfers to others, it does not lose energy in the process; It actually gains it.
I guess that's what makes results vary from person to person.
Hard work + heart work = success.
And in the equation above, the relationship is not additive. It's synergistic.
So wherever you're planning to go next, take your heart with you. And, whatever you're planning to do next, add a cup of passion into it.
Personalize your work. Make it human. Because perhaps, that's the only way that will make it matter.