Cool quote to describe the problem of applying technology in medicine

The paradox is that hospitals have 21st century needs, 20th century technology and 19th century budgets.

Walking with both legs

I recently watched the North American premier of Zhang Yimous new film Under the Hawthorn Tree. During the post screening Q&A, Zhang commented in response to a question about the tension between art films and commercial films that as a Chinese filmmaker today one must “Yung liang tiao tui zou lu”. In other words, he went on one must help China protect it’s market for filmgoers the young 20-30s who want to see Hollywood style movies while at the same time making films for filmmaking or “arts” sake.

I found these comments to resonate deeply with me. In the face of conventional wisdom and social pressures to package each of us neatly into one single career or passion, I’ve always thought of my own career as one in which I am constantly balancing several interests for which no single professional activity alone can optimize. I keep coming back to the three I’s impact, independence and income. I must optimize all three in my mind to be successful. Impact in my view has to do both with personal sense of accomplishment as well as social approval. One should not only feel a sense of satisfaction at the purposefulness and meaningfulness of ones work as well as achieve some socially determined recognition of success. Independence, having a loved and loving family behind ones career is vital. The support that my family and Jane provide me is critical to my ability to function at a high level. Finally income, how good is money at measuring the impact of ones work? I’m not sure but I do believe it is an important measure whether you are a nonprofit attracting donors and donations or a large consumer goods company tracking sales or an investment bank managing a portfolio of assets, the more dollars your work affects the more value you create and the more risk you bear ie the more impact you have. Income is at least a part and in my opinion a big part of the picture.

So where does that leave me? What are the two legs of my walking success story? One is as a Doctor, I am more sure of this every day. The next well we shall see, I have a feeling it will have to do with the business side of healthcare. Stay tuned . . .

Motivation

What is motivation? According to wikipedia the word is defined as “the activation of goal-oriented behavior”. As I sit in my house looking at my google calendar, at all the meetings later this week, putting the final touches on my vacation schedule, noting the 7 overnight calls i will start the following month, I feel a mild anxiousness. Its not a full blown dread at the work that is forthcoming or even an anticipatory nervousness or performance anxiety. Rather is a dull agitated feeling in my gut that I am not doing what I should be in life. Its an uneasy sense that I am not going the right direction coupled with a mild frustration at not being able to find the right direction combined with a paradoxical nihilism of why finding a direction even matters. Either way I feel particularly lazy, unmotivated, stagnant.

So why is it that I feel like I am procrastinating even though I have nothing really to do? I suppose even though I am still undergoing my medical training, have made a ton of friends in my new program, I have gotten into a routine of having extrinsic goals set for me over the last 5 years to the extent that I have lost a lot of intrinsic motivation to set and execute my own goals. Its interesting, even doing laundry or cleaning my room as gotten to be a chore whereas presenting at a conference or turning in IRB proposals and setting up meetings for research have become routine.
It doesn’t help that in the midst of all of this, I am feeling my attention span get shorter and shorter as I get tired, have even less time as a resident and feel the pressures of the mid 30s modern day life start creeping up.
Hmmm, we’ll keep thinking bout this one

as I think back to why I decided on medical school now 7 years ago and the last time I had this uneasy feeling