As I’m entering the final phase of my residency, I only now understand the greatest benefit of this time as an assistant doctor. The psychosomatic hospital I work at is huge, and that has many perks, like getting in touch with and learning about a wide range of disorders. But what I am referring to is different from my actual practice; it’s talking about it.
It’s about sharing my work.
The easier route would be to hide behind satisfied patients. I get along well with most of them; our relationships are stable and constructive. That alone is of great value for the therapeutic process.
However, patient satisfaction shouldn’t be the highest goal in medicine. While it is a welcomed side effect of successful treatment, it should not rank at the top of the hierarchy. Instead, the patient’s long-term wellbeing should serve as the guiding principle. This often requires risking short-term discomfort. In the treatment of anxiety disorders, for example, discomfort is necessary for successful confrontations.
Of course, pursuing long-term wellbeing has to be embedded in an ethical structure. Beneficence, non-maleficence, autonomy, and justice are commonly referred to as the four pillars of that structure.1 Conflict between these pillars can arise quickly, and they must be constantly weighed against each other.
According to non-maleficence, no suffering or pain should be inflicted on the patient. According to beneficence, the treatment should promote the patient’s welfare. What does that mean for exposure therapy, a key component in CBT’s approach to treating anxiety? Even though it can be very unpleasant and demanding for the patients, it remains the recommendation in the guidelines for panic disorder and agoraphobia.2 According to the data, the long-term profit outweighs the temporary discomfort.
Applying the recommendations of guidelines can be a challenging endeavour. Timing, dosage, and implementation are only some aspects that must be considered in each intervention. Working within a clinic’s established structure helps to build routine and intuition for these processes. Part of this structure are various forms of supervision and regular team meetings. I found that sharing my work in those as detailed as I can is the key to treating my patients effectively, without working only towards their momentary satisfaction.
Talking about my work makes me think about it, which often results in connecting new dots or sparking new ideas. The feedback from my team and supervisor is invaluable, but even if no one commented, sharing the details about my processes would be worthwhile. Committing to this makes me sharper outside of the team sessions as well because I know I will report later on what I’m doing now.
I have to admit, that’s not always easy for me. Making my work public and risking criticism is frightening, not just in my professional life. I had the same difficulties with my art. Initially, publishing songs online and exposing myself to the world’s reviews was very difficult. Only after making close to 100 beats did I dare to post one publicly. I have been doing it for many years now, and most of the fear has been replaced by excitement.
The same will be true for the fear of criticism of my work as a doctor. This has also decreased significantly since I started my residency in 2019. I continue to practice diligently and report as detailed as possible to my team and supervisor. I research or ask questions and make my inner conflicts transparent for discussion, even though it often makes me uncomfortable. Then I try to remember that I should treat myself the same way I treat my patients: With long-term wellbeing as the highest goal – Investing not just in the being, but in the becoming.
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Summary
- Long-term wellbeing is more important than momentary satisfaction, not just in medicine 😛
- Talking about something makes you think about it – which is often enough to connect the dots or spark new ideas.
- Sharing your work might be frightening, but it won’t stay like that if you keep at it.
- Invest not just in who you are, but who you’re becoming.
✒️ Quote of the week: “Consciousness is already free of the problem you’re trying to solve in this moment”, by Sam Harris. Quite relevant for the essay’s topic. It means to observe the fear of judgement and criticism as a temporary appearance in consciousness. That’s perhaps the most effective way of reducing the grip of it and moving freely.
📃 Article of the week: Dive deeper into the topic of ethics and subjectivity with this article from Nautil.us – Animals Feel What’s Right and Wrong, Too.
🍿 Video of the week: Kurzgesagt is one of my favourite channels on YouTube. This is their latest video about why we can’t see all the alien civilisations that should be out there – There Are Thousands of Alien Empires in The Milky Way
🎧 Song of the week: acidbrain, 1ony – In My Lane has been my hymn this last week. Just good vibes for sunny days, or to bring some of that into a rainy day when needed 🙂
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