“You can’t learn if you think you already know. You will not find the answers if you’re too conceited and self-assured to ask the questions. You cannot get better if you’re convinced you are the best.” Ryan Holiday — Ego is the Enemy
“Dr. Day, I don’t think this is going to work out between us — I’m going to find someone else”. I saw Steve today in clinic — he spoke these words to me while avoiding all eye contact. This was the first time I had seen him since we had a difficult encounter earlier this year, which I had written about:
“Why didn’t he listen to my advice? Why does he waste my time in clinic if he doesn’t want to follow my advice, when I could be seeing other patients who listen to what I have to say?.”
Today, mindful of how our last encounter went, I made sure to get myself into a calm, welcoming mindset and made an intentional effort to let go of any frustration I had felt before.
However as Steve spoke these words I could see Steve was anything but calm — he was nearly having a panic attack. As we discussed it further, it quickly became apparent that I was the trigger for his panic attack, given how our previous visit had went. Shortly after he mentioned this to me, he abruptly ended our visit, and that was it.
First, Do No Harm
It would be very easy to think “great, one less problem to deal with” or “well, that’s his loss” or “good riddance” and leave it at that and move on. However if we take a step back, what has really been accomplished by this outcome?
Ultimately I have atrociously failed to help Steve. What’s worse is that I have harmed him. Not only does he still has untreated medical conditions but I have just created a new one that may impede him from seeing a doctor in the future. In retrospect, I have violated the Hippocratic Oath — I have harmed Steve.
Ego and Arrogance vs Modesty and Humility
Reflecting back and reading my previous words it’s very clear to me that my initial reaction of frustration and annoyance were driven by my own ego. When Steve doesn’t follow my suggestions and his conditions worsen, I see this as evidence that I am not an expert, as my perceived expertise is not solving this problem. In response to this direct insult, my defence mechanisms activate, and I think:
Why doesn’t Steve value my expertise, that I have toiled so long to gain?
Why doesn’t Steve listen to what I have to say, when other people will?
Why does Steve waste my time?
In reality, when I move past this initial defensive thinking and put my ego aside, the questions I should be asking are:
Why is my approach failing to make a difference for Steve?
What can I do differently to help Steve with his conditions?
What short comings do I have that are contributing to the problem?
If instead I valued the outcome (helping Steve) rather than my ego (maintaining the image of an expert) things may have turned out different.