Anecdotally Speaking

The superfluous, a very necessary thing. --voltaire

Monday, February 05, 2007


Practice Makes Perfect

"To demand perfection is to deny your ordinary (and universal) humanity, as though you would be better off without it." --David Bayles & Ted Orland, from Art & Fear, Observations On The Perils (and Rewards) of Artmaking"

With this quote in mind, I want to revisit the mantra expressed by the Chief to his Surgical Resident, Dr. Bailey, in the drama "Grey's Anatomy."

"Dr. Bailey, this is a patient like any other patient, there is no room for error, which means there is no room for nerves, shake it off."

Elsewhere, writing on perfection, Bayles & Orland state: "If you think your work is somehow synonymous with perfect work, you are headed for big trouble. Error is human. Inevitably, your work will be flawed. Why? Because you're a human being."

There are two aspects of her basic humanity that the Chief is asking Dr. Bailey to set aside. One is the tendency toward error; the other is the capacity for experiencing emotion and the implication that this emotion can increase the likelihood for error to occur. As a doctor, she is being asked not to make a mistake and not to let her emotions cause her to make a mistake.

How can a human being perform work error free and unaffected by emotion? Dr. Bailey's mentor advises her to "shake it off." My experience in medical education and training has been that there has not been any advice in this regard any more explicit than this. Nevertheless, the implicit and tacit pressure to demand of ourselves perfection, and indeed thereby to deny our ordinary humanity, has, in my experience, been the way we were shaped into physicians.

To what end? To make good doctors? Maybe. To make good people? No. Wounded people, certainly. You cannot deny your true humanity, your true self, who you are, and emerge unscathed, no matter how noble the cause.

However, maybe there is something even more insidious at work, something ultimately more harmful in the end, than the injury to the healers themselves. Trading their humanity for perfection may be more than a bad bargain for the doctors, but may be a bad deal for their patients as well.

Bayles & Orland: "Your perfectionism denies you the very thing you need to get your work done (it denies you your humanity). Getting on with your work requires a recognition that perfection itself is (paradoxically) a flawed concept."

On reflection, I wonder if it has always been this way. Terms such as "the art of medicine" and "medical practice" harken to a time when there was no expectation that a physician always had the necessary or typical characteristics required for any given situation, complete, lacking nothing essential, without errors, flaws or faults.

Does practice make perfect? Twenty-nine years of practicing and I haven't made it yet, to perfection that is. Please don't let that secret out though. It raises another interesting question, however, how does one define a "good doctor?" Is it one who does not make mistakes? Save that question for another time, perhaps. Anyway, must get to the office, back to my practice. More practice; practice makes perfect, you know.

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