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Overcoming the Durability of 'Won't' in Life and Rad Career


Are we defined by self-imposed limitations or our adaptability to changing circumstances?

Long-term readers of this column may recall that half of my fitness regimen is distance running, and during my temperate zone winters, I rely on treadmills.

It’s not that I can’t run outdoors at that time of year, I just decided, at some point, that I won’t. I have my reasons. There is much less daylight, and I’d rather not run in the dark, lest I get hit by a car. Huffing and puffing the cold air offends my respiratory passages, leaving me with a sore throat, nagging cough, etc. Snow and/or ice on the ground could be hazardous to my footing. Plus, there are other, weaker excuses, such as not wanting to become a sweaty mess when I’m all bundled up.

Throw together enough won’ts or just a few strongly felt ones, and you might as well have a can’t. One can rehash the reasons but they fade into the background. All that remains is an awareness of what’s not going to be done, and an acceptance that this isn’t going to change.

This can be useful. Familiarity with your limits (or those of others on whom you depend) lets you work around them, rather than waste time and trouble banging your head against the wall in a frustrating cycle of futility.

However, an awful lot of won’ts and can’ts aren’t so adaptive. Many are just self-awarded excuses not to try things. I don’t have to challenge myself and test my limits if I’ve already accepted that those limits are insurmountable. It doesn’t matter whether a particular “won’t” is a brick wall obstacle, or a flimsy flap of linoleum with pictures of bricks on it. If I don’t even take a poke at it, the thing is 100 percent effective against me.

Recognizing that I can or should ditch a particular “won’t” is often a gradual affair. Even once that happens, it can be agonizingly slow. A protracted psychological campaign, chipping away at barriers I created for myself, can be mentally exhausting with plenty of opportunities to give up.

Fortunately, I’ve stumbled across a much quicker and easier way. Think of something at least as durable as the “won’t” you want to smash — an opposing “won’t” or “can’t” that matters more to you —and use it to bludgeon the offending one to smithereens.

A case in point was my indoor running situation. I knew that my fitness would be better served if I ran outside than on my treadmill all winter but I had determined that I wouldn’t run outside. That situation was tolerable enough until my treadmill died last week. It would take a while to replace the thing. In the meantime, I could run outside or not at all.

All the reasons underpinning “I won’t run outside” were ready to stand in my way. But “I won’t get out of shape” was stronger. I mumbled and grumbled a bit, but between those opposing won’ts, there was really no contest. I resumed running outside.

There are plenty of won’ts and can’ts in my radiological life. When I first went into telerad, for instance, I was leaving behind six years of daytime, mostly Monday to Friday outpatient work. I thought: “I can’t go back to working nights, reading inpatient and ER studies full-time.” “I can’t work seven days in a row.” “I can’t make pay-per-click work for me.”

All of these objections got smashed up pretty handily by my psychological sledgehammer. “I won’t let this lousy job market stand in the way of my career” and “I won’t take a step backwards from the dead-end job I just left.” Presto, I reacquainted myself with hospital-based imaging, learned new efficiencies, and increased my bottom line while working 26 weeks per year.

Changing jobs often has such a feel for me. Every time I’ve found myself a new opportunity, it’s because my former gig, on one level or another, has given me its own barriers to break. “You won’t find a job paying you more than we already are (so we don’t have to give you a raise).” “You won’t ever be more than an RVU generator.” “You can’t be a telerad and have a path to partnership.” All of which I’ve answered with variants of “I won’t let this radgroup limit my professional growth.”

Growth is, in fact, what I find most often results from using my won’t-breakers. It’s how I changed my perception of a solid day’s work from dozens of cases to two or three hundred. (“I can’t read that many cases” collapsed when faced with “I won’t be in the bottom percentiles of this radgroup.”) It’s how I relearned a lot of the neuroradiology I lost when I’d been in a group where subspecialists took it all. (“I can’t read neuro anymore” fell to “I won’t give up those skills for the rest of my career.”)

Once I got comfortable breaking my won’ts, I found it wasn’t all that different to use the maneuver with others. That goes for individuals as well as groups (such as the other rads on your team). If you let them, they’ll often tell you everything you need to know: What barriers they’re struggling against as well as what might motivate or enable them to press beyond the obstacles. Sometimes, all you need to do is help them connect the dots.

Folks who’ve dealt with children are generally familiar with this maneuver: “If you won’t do X (or stop doing it), you can’t do/have Y.” An extra layer of difficulty is that your immature audience might not accept the either/or nature of the situation. Unhelpful reactions can vary from ignoring the choice to having a tantrum over it. Sometimes full-grown, presumably mature adults will respond in similar fashion.

When that happens, I find it’s best not to force the issue. Regroup and confront the “won’t” later on, maybe when you’ve thought of another way to present it or when your audience is in a more receptive mood. I even experience this when dealing with my own can’ts and won’ts. If I have other things distracting me or I’m just not in the right frame of mind to break some barriers, I set aside the won’t hammer. Later on, I might be able to wield it more effectively or come up with an even sturdier tool to use in its place.

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