The Doctor OS: Outer and Inner Forces and Rock Climbing
In the last email newsletter, I started to talk about the Doctor Operating System that helps us run the Doctor Channel. By Doctor Channel, I mean our performance, our user interface: how we receive and transmit information, complete tasks, do procedures. I mentioned that the Doctor OS is shaped both by the outer world and our inner world. Many of us would agree we have a much clearer idea about how the outer world informs the OS than the inner world—after all, that's explicitly conveyed by our curriculum, professional standards, and the experiences we have meeting professional expectations to fit into the clinical setting. In fact, for a very long time as we're training, it seems there is shockingly little interest in our experience or point of view. In subtle and not-so-subtle ways we learn to master our wants and needs to minimize their interference with our performance, which becomes an important measure of our suitability for this profession. Our ability to override hunger, loneliness, irritation, or exhaustion can seem on the most basic level to indicate our discipline. On another level, it signals many other things, too, ranging from our endurance, ability to put patient's needs before our own, and reliance on objectivity to help us maintain presence of mind during crises. Obviously, it's not just during training that we conform to expectations from our employers and standards set by our professional associations. So it makes sense that we may be much less aware of how inner determinants also contribute to the OS.
Spelling out the perceived value of mastering our feelings might seem insultingly simple. Why would I waste your time with this? The reason is that it clarifies a bit more of how the Doctor OS is installed, and it enables us to address its constituent parts and strategies—its algorithms—more directly. We might still agree with the objectives of certain professional expectations and behaviors, but we might also begin to discern a wider range and perhaps superior means of satisfying them.
If you've ever rock climbed, you might know on a physical level how the rock starts to reveal itself as you climb. Features that were invisible become, in the relevance of reaching for purchase, hand- and toeholds. In essence, when we grapple with the rock we enter into a different relationship with it, and it almost seems to come alive under our hands and feet. The trivial becomes significant.
These "hand- and toeholds" begin to illuminate ways to interact with or reshape the Doctor OS from the outside, but what about the inner contributions? No matter how logical or how oriented we are to the external determinants, we always see and feel them through the filter of our own experiences and ideas. Isn't that the case that virtually everything we take in? That everything we learn is compared to what we have already assimilated? We make assessments of what is "this and not that" and fit things into pre-existing categories to apprehend and decide to trust (or believe) them, even when it means modifying existing categories or building new neural pathways. Things either have to pass a common sense test or cohere with a principle that already has, which is a little like our inclination to trust a friend of a friend more than we trust a stranger. It would also make sense that certain pre-existing "templates" are common among physicians and may underlie our motivation to travel this career path. Bringing these onto our mental screen, into awareness, can also help us understand why we subscribe to things or experience things in ways that conflict with or even contradict what we consciously believe. It can also help us trace how we make agreements to things that are not in our own best interest or even reasonable for us or our patients. Next time, I'll give the example of the wounded prince and how important he is to all of us, regardless of our gender.
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