The Imperfect Radiologist

We have been trying out a “meal kit” delivery service recently. Hitting grocery stores and concocting our own recipes isn’t beyond our capabilities. However, with a couple of hectic schedules, it is all too easy to lean on pricier and less healthy takeout and delivery options.

In my household, I am not the one with great kitchen skills. I could blame that on having less time to learn. With vastly more hours spent in school, post-grad training, and doctorly work. I could also point out that my tastes are simpler. Left to my own devices, I might never reach for the spice rack.

Really, though, I just don’t groove to it, and it doesn’t seem coincidental that I was totally uninterested in chemistry lab as well. Following directions to properly measure things out, mix them the right way, heat them sufficiently (but not too much!) is not my bag baby. Snape would not have been my fan if I had attended Hogwarts.

Still, if cornered, I can do it, and when my lady was getting home later than usual, she asked me to put together one of the “easy” meals we had in the fridge. It probably took me twice as long as it would have for a capable individual, and I was kind of a nervous wreck that I would screw something up in the process, but it turned out well.

At least, she said it did. Maybe that’s because it truly was “easy,” and I would have to be completely incompetent to screw it up. The thought also occurs that her expectations of me in the kitchen are low enough that she would praise anything short of coming home to a fleet of fire trucks.

Lest it fail to have come across, I am not shy when it comes to pointing out my imperfections. Somewhat paradoxically, I think that might have come from being a perfectionist in various settings during my upbringing and early adulthood. It is a more than common trait amongst those of us who competed our way into medical careers.

When you have learned to flagellate yourself over every missed point on exams and botched question during rounds, you develop a keen eye for things in which you can’t — or needn’t — excel. Some folks proceed to avoid those activities entirely. Others have enough energy and faith in themselves to strive towards excellence in everything. I may stink at underwater basket weaving now, but just you wait until I have mastered it.

All of that sounds needlessly stressful to me. I have never had a prayer of playing a competitive game of golf or tennis but wouldn’t want that to deprive me of the enjoyment I get from them. I also don’t bother with professional lessons and intensive practice to improve my game. That seems more like work than fun.

Still, the perfectionist streak is a sneaky thing. Every now and then, I realize I am getting cross with myself for performing poorly in something that I know I am not particularly good at. One way to diminish that is to stay in the habit of admitting to myself (and others, when relevant) that I am not very good at X, Y, or Z.

This can easily be overused. One doesn’t want to become Debbie Downer. People tend to be attracted to positive energy, and a steady drumbeat of “I’m no good” is an energy vortex. Further, even if it’s only part of one’s internal monologue, it has a way of making itself truthful, like an inverse self-affirmation.

In addition to keeping my perfectionism in check, I have found this useful for modulating other folks’ expectations of me. Especially in health care, individual capabilities range widely, even within a particular subspecialty. Folks unfamiliar with me won’t know where my radiological strengths lie unless I tell them.

Someone might ask me what I think about an ankle MR, unaware that I haven’t read those in decades. Even when I tell him or her that, if I’m the only rad this person can find, he or she might still want to hear my opinion, but at least will know not to put too much stock in it.

It can take a few repetitions for folks to understand, accept, and remember what you tell them about your imperfections. At my last job before going telerad, they wanted to make me their breast imaging guy, biopsies included. I advised them I am not a great one for hands-on procedures, but they were sufficiently keen on it that they pressed the issue. Ultimately, I played ball in the name of “building the practice.”

Next thing I knew, they moved on to thyroid biopsies, and since I was already sticking needles in people, they had a foot in my door. If I hadn’t already expressed my discomfort with what was going on a few times, they might not have laid off. As it was, they relented and tapped one of the other rads for the task.

There is one other useful thing about the ability to own your imperfections. It can put others at ease. We have left the age of Dr. Kildare and his like behind us. It’s not a given that folks regard physicians as noble pillars of excellence, unquestioned as the smartest guys in the room. It’s far more common to see folks wanting to take doctors down a peg or two.

In that kind of environment, if you occasionally offer up a tidbit showing that you recognize and can even joke about your own fallibility, others might be less inclined to do it for you. That goes double for when you’re dealing with other docs (fellow rads and otherwise).

I recall one individual in my residency who expressed a desire to become “the smart one” when she perceived that a year-mate had that reputation. Meanwhile, the subject of her envy was far from boastful, or even aware of any such tension until he was quietly made aware of it. At that point, there wasn’t much he could do.

I don’t remember if he had engaged much in the preemptive self-deprecation I have been talking about in these past few paragraphs. If he had, there would at least have been less of a chance for anyone to form the impression that he was putting on intellectual airs.