The epiphany collector

Risky business

It can be unnerving to be an epiphany collector. If we doctors were really honest with ourselves, we might admit that the negative experiences, while probably far fewer in number, are given more credence emotionally than the positive ones. Maybe that should be an epiphany. It can be hard to know how to learn from our experiences. To be a good doctor, I am convinced that reflection is necessary, yet ironically self-assessment is often inaccurate.¹ There will always be some physicians who will attempt neither.

Longevity

I am also convinced that we need to collect epiphanies to ensure our professional and personal longevity. Epiphanies provide much-needed balance for at least 2 good reasons. First, they afford us meaning. When we choose to embrace diverse opportunities in our professional world, we encounter circumstances that move us out of our comfort zone. Yet there are those times after working in an underserviced neighbourhood or Third World country that we remember what really matters in life and why we wanted to do what we do. There is also the potential for a greater sense of meaning when we witness the clinical epiphanies (those “aha” moments) that medical learners experience because of our guidance. Those nourishing epiphanies offset the less-than-delicious ones.

Second, we need to collect epiphanies because exchanging them with others can foster community. Community protects us from burnout, or at least from one of its symptoms—cynicism. Meeting with peers or mentors and sharing our reflections has therapeutic value. Literature has shown that connections to social support systems can be key to preventing physician burnout.² I recall my first days in practice when a wise physician associate listened to my perception of a clinical blunder, then gently provided objective counsel. His experience became my comfort. I benefitted from his years of epiphanies, and his insights restored my perspective. I now find myself in the company of a greater number of medical residents and younger physician associates. I am increasingly comfortable with being transparent about my years in medicine and I find our encounters to be nurturing and restorative.

A triad

I am less persuaded than ever before that my coroner friend had it right at all when he suggested that physicians belonged in one or the other category of an approval dyad. We are far too complex. There are countless combinations. There are physicians who like research and those who do not. There are physicians who need power and those who do not. There might even be physicians who collect epiphanies and those who do not—or perhaps not yet. A triad.