To All My Fellow Underachievers


Underachieving is not permanent in radiology.

I morphed into an underachiever during the second half of high school. Prior to that, I’d been a hypercompetitive lad, scrambling for every last academic point and honor I could get. Nothing trumped the importance of getting into the best college possible.

The circumstances under which I determined that there was more to life than this, and that it should not eclipse everything else, aren’t worth going into here (and, besides, I have to save something for my autobio if I ever write one). Upshot is that, while my academic performance didn’t quite tank, it got less stellar. And I was much less high strung about it.

Almost not getting into med school was a wake-up call, and I did put more effort in subsequently. I had, however, seen that life could be something beyond the learning of every darned factoid I could for flawless regurgitation on exams. And accepted that not everything needed to be about optimally positioning myself for the next phase of my career (internship, residency, fellowship, etc.).

So I did a decent job-scored Honors in multiple classes, dabbled in a bit of research, and still intermittently reached for the brass ring. The overachiever remnant left in me nevertheless noted that others were doing more, and might go on to bigger and better things. I didn’t so much care about that; I’d determined that climbing the hierarchy of an academic ivory tower was not my interest.

Still, I slowly but surely saw that I wasn’t turning out to be the best rad I could be. I didn’t always have the answers in conference, or even in the reading room. Where others made studying a full-time pursuit, I had a hard time motivating myself to hit the books (except for when an exam loomed). I didn’t feel particularly ashamed of it; seemed reasonable to me that I was putting in 10+ hours per day in the hospital already, learning by doing. How much more should I be demanding of myself?[[{"type":"media","view_mode":"media_crop","fid":"63284","attributes":{"alt":"Underachieving radiology","class":"media-image media-image-right","id":"media_crop_2728542422666","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"8076","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 147px; width: 170px; float: right;","title":"©Lorelyn Medina/","typeof":"foaf:Image"}}]]

Emerging from training, I swiftly saw the suboptimal payoff of my incomplete efforts: I wasn’t a brilliant radiologist. True, I had plenty of colleagues no more capable than myself…but that was cold comfort. On a daily basis, I found myself wishing I’d paid better attention in lectures, studied harder, and generally cracked the whip on my younger self just a bit more. If I had, it seemed to me, I’d be plowing through my daily workload with much greater confidence and capability, instead of uncertainty and anxiety.

A funny thing happened, though: Stumbling my way through those early post-training years, in fits and gasps, I filled the gaps in my knowledge. Belatedly, without the structure of an academic program, I was finally understanding what (it seemed to me) I should have learned 5, 10, even more years earlier.

Maybe it’s that I was no longer in an environment where every day was chock-full of material to commit to memory, and I could more readily absorb it in smaller doses. Maybe it was that this stuff was all in the context of my work: More practical, less theoretical. Maybe it was that I had experienced what it was like to be less than capable, and been “scared straight.” Whatever the mechanism, I found myself actually enjoying learning things for a change, and feeling more capable every time I did.

It has occurred to me, more than once, that I might be even more capable by now if I hadn’t squandered learning opportunities in years gone by. It’s also occurred to me that, if I hadn’t become an underachiever pre-college, and continued to give 110% for the subsequent decade or two, I might just have been postponing things. I might have gotten out of fellowship, totally burned out, and thought: “At last, all that hard work is done. Now I can relax and enjoy a nice, cushy career.” Maybe I wouldn’t wind up all that attuned to learning new things afterwards.

This is not meant to be a confession of my underachieving sins, nor to encourage others to laugh off the responsibilities of today with the expectation that they can just as easily be attended to tomorrow (or next decade). Rather, it’s a bit of encouragement: Your potential is your potential. Failing to realize it in the past does not mean you can’t do something about it now.

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