The Bizarre Easter Story

The Bizarre Easter Story

If someone were to give an analogy for the Easter story, it’d look something like this:

A zookeeper and his son are on a walk discussing the recent events at the zoo. The zookeeper turns, bends down and says to his boy, “Today, a lion slipped into the llama pen and killed two llamas. Yesterday, another lion killed our koala. Last week, two of them ate the camel. And the week before, it was painted storks and grey herons. And who’s to say for sure who snacked on our golden agouti? The situation has become intolerable. Something must be done. I have decided that the only way the lions can atone for their sins is if I feed you to them.” *

What?

The Easter story is bizarre. There’s supposedly an all-powerful, perfect God who created the whole Universe, except God’s imperfect creation (humanity) rebels against Him in every way possible and God resolves this how? By giving up his perfect Son, a part of himself, to die and save humanity. This defies human logic on so many levels, that if any ordinary guy tried adopting this reasoning, I’d imagine his friends would slap him across the face and tell him to get a grip. But let’s unpack this bizarre Easter story with two questions.

Q1: How badly did humanity screw up for God to resort to send His perfect Son to die? People often point to the resurrection as being a stumbling block for Christianity but if Jesus was truly God the Son, it’s not strange that he, the author of life, should conquer death. Rather, it’s much more startling that he should die at all than that he should rise again. As Charles Wesley wrote, “’Tis mystery all! The immortal dies”. So, creation would’ve had to fail not just a little bit, but a lot for this price to be paid. Idea 1: Humanity sucks, a lot.

Q2: Why did God pay this price? I mean, surely wiping creation out and starting over again would’ve been a more logical approach versus sacrificing your Son? The only answer is simply out of love: pure, unconditional love. If that seems crazy, I don’t blame you – it’s radical, mind-boggling and almost unbelievable. Idea 2: Humans are loved, a crazy big lot.

And yet this Easter weekend, billions of people across the world treat this Easter story as an Easter miracle, with many pointing to the event of Jesus’ resurrection as the basis for their entire life. To me, it seems confusing why anyone would defy logic and accept this bizarre Easter story without a good reason to. Perhaps the ideas from this story give us a clue: that we are more broken and flawed than our wildest dreams, yet at the same time, loved more than we could ever dare hope.


Footnotes
* This analogy was inspired by The Life of Pi.

Restless Searches for Meaning

Restless Searches for Meaning

Disclaimer: The following post is dark, with themes of meaninglessness and suicide rearing their heads. I’ve put off writing this for some time now, but a part of me urged me to do it, partially to confront my own demons, but also to reassure others that they’re not alone in distressing moments. Honestly, my mental health is fine, but episodes like what you’re about to read do occur from time to time; I suspect that for others, this dialogue is hauntingly familiar in little ways. Remember, there is always someone you can talk to: you are not alone.


2am.

Or something around there – I’m not too sure. But it’s definitely been a while since the kindle got put away, the lights got turned off and I hopped into bed, which was around 1:30am. Taking that nap in the afternoon was definitely a mistake, I think to myself.

As the night progresses, still wide awake, something slowly but surely begins clawing its way into my head. It’s my inner darkness, one which loves to do nothing more than throw everything I know and believe into chaos. Usually, I keep a tight lid on it but tonight, my defences are down. The darkness lunges at the opportunity, slithering into my thoughts with its sickly-sweet voice.

Hi Eric, how’s it going? Done anything special recently?

It’s a trick-question, one meant to lower my guard. The best way to deal with this is simply to ignore it and not let the voice get what it wants. But despite my best efforts tonight, the darkness doesn’t let go – perhaps it senses my vulnerability. Finally, I give in.

Look, I have a meeting tomorrow morning and I’d like to sleep right now if that’s alright. Can you go away please?

Oh, so you think your meeting tomorrow is more important than what I’ve got to say to you? No, stay child – and listen carefully.

I already know what’s coming, but before I can shut the darkness away or brace myself, the onslaught begins.

Look here, everything is meaningless. One day, you, your family, your friends and everyone you care about will die and be forgotten. Time and death are two relentless forces that won’t stop for anyone. You know what this means? NOTHING YOU ACHIEVE IN YOUR LIFE WILL MATTER. You’ll be forgotten, just like the billions of people that have died before you. And you think you’ll change the world? Hah, believe me, you’re just nowhere near as special as you think. There are SO many kids smarter, more driven and with better opportunities than you that will go on to achieve successes you could only DREAM about. No, Eric you’re as ordinary as they get. WAKE UP.

Ah yes, good old nihilism. It’s an uncomfortable argument, but one which I’ve come to terms with over time. The dance between us continues, in a variation that’s been played out before.

Well, I see where you’re coming from and indeed, it does seem depressing. However, I believe in a God who created heaven and Earth; one which gives meaning for people’s existence and real value on my own and others’ lives. This means that-

This whole Christian thing again? Let’s be honest, you don’t really believe in God. I mean, when’s the last time you shared the gospel to someone? If you really believed, you’d be declaring the ‘Good News’ to all the corners of the Earth. Yet here you are, living a comfortable and selfish life in your 2-bedroom apartment. You’re as fake as they get, admit it.

Okay, I agree that I could be doing more to share my faith and I’m working on it thanks for the reminder. But I also understand that you don’t have to necessarily tell the gospel to evangelise, and I trust God’s plan to manifest itself in everyone eventually. How-

God’s plan?! How do you even know your God exists? Look at the times you’ve felt closest to God – a death in your family, a close friend’s conversion. It’s just your unconscious responding to emotional experiences: exactly Freudian psychology in motion! Stop using God as a defence mechanism, a replacement father figure, and just come to terms with the truth: life is cruel, meaningless and has no explanation.

Oh, so you want to bring up Freud? You know that psychoanalysis has no credible evidence behind it – can a case study here and there really be applied to everyone? Isn’t believing in psychoanalysis a form of improvable faith in itself?

Oh, tricky, tricky. Look, you can believe whatever you want but I promise you, you’re deluding yourself. You could jump off your balcony head first right now and crack open your skull and the world wouldn’t notice. You’ll be remembered for an infinitesimal amount of time before everyone that cares about you dies as as well, where you become just another number on a stats website for suicide.

So should I just kill myself then? Is that the only path ahead for a nihilist?

The darkness inside me pauses. It doesn’t want to die – not right now. I suspect that under all this bravado, the voice is simply searching for its own sense of meaning. A yearning for a reason behind the suffering, the chaos and the evil in the world we live in. In its pursuit for meaning and realising nothing the world had to offer was enough, part of it resigned itself to nihilism, and now aims to take down the rest of me with it. But I sense some part of the darkness is still desperately hanging onto a possibility of meaning within this space of randomness, which may justify living just one more day.

The voice finally leaves, and I lie silently for a while, still awake. Eventually, after what seems like another hour, sleep manages to find and wrap itself around me, until I finally fall prey into the bizarre world of dreams and nightmares.

Defending Inputs

Defending Inputs

Beware the stories you read or tell; subtly, at night, beneath the waters of consciousness, they are altering your world.

– Ben Okri

When I was a kid, I used to obsess over this type of Lego called Bionicles. It was more than just blocks and pieces, there was this whole universe about it – movies and comics with heroes and villains and twists and turns, and 5-year old me devoured it all. When I went to Big W with my parents, I would always beg them to buy me a new Bionicle to play with. And usually, out of what I now suspect was a ploy to get me to pipe down, they complied. Little did they know how much these toys would take over my time, thoughts and obsessions.

From the ages of 5 to 7, hours each night were spent on my bedroom floor with swarms of Bionicles pieces in front of me. During these hours, I’d create epic battle scenes, new ‘hybrid’ Bionicles and a complex story with my figures which I thought was honestly pretty good. At the peak of my obsession, I even created a card game out of Bionicles. For each card, I would give each unique Bionicle a name, a ‘description’, some attack/defence stats and draw its face on a piece of paper like a Yu-Gi-Oh card. Looking back, it was absolutely ridiculous but as a kid, I was in my own little world and I loved it.

This strange phase of my life illustrates how my inputs directly influenced my outputs. It was only through my constant input of Bionicles: the movies, comics and buying new figures, that I was able to fuel my ideas of storylines, new figures and even a card game. If I had never taken any of these ‘Bionicles inputs’ in, there is no chance any of these weird ‘Bionicles outputs’ would’ve ever transpired.

Of course, this concept applies to almost all domains. If you want good grades, you’d better learn the lectures. If you want a healthy body, you’d better eat right. And if you want to be an epic Bionicles producer, you’d better have some interest in what the Universe and characters are like. Our outputs are directly influenced by our inputs.

OutputNecessary Input
Good gradesLearn stuff
Healthy bodyEat right
Epic Bionicles ideasObsess over Bionicles

This seems obvious. But due to the enormity of the information available on the internet these days (let alone podcasts, movies or books), there is huge potential for our ideas about ourselves, the world or other people to be radically altered. Whether it’s a subtle Facebook comment or an alarming news headline, the amount and diversity of stimuli out there that we can interact with is astronomical. This means negative and unproductive stimuli can hurt us, inspiring and exhilarating stimuli can build us up, but on unprecedented levels.

Which leads to the idea of the importance of developing ‘intentional inputs’. Whether it’s reading good books, avoiding unproductive pieces of information or having a stronger filter, controlling the ideas and products we input can help make dramatic changes in our outputs, whether that’s ideas, physique or anything in between, illustrating the ever-increasing need to defend our inputs.

I’ll admit, this can be uncomfortable as it creates responsibility on us to decide how we want to see things, and responsibility can be scary. But at the same time, this notion of defending inputs is also remarkably liberating, as the ideas that shape how we see the world can be slowly but surely moulded into something new, if we only decide to choose so. The potential for this is enormous.

So what you need to do, if you really want to broaden your horizons as a listener, is to get exposed to new things. Pick somebody. It doesn’t have to be me…. Find somebody who you trust as a guide, and let them open your ears to these new experiences.

If you do that, you will be rewarded infinitely…

– Ted Giota, from a podcast episode on Conversations with Tyler.

On another note, I’ve been enjoying writing recently and so I’ve decided to write more during this Easter break. Starting today, I’ll aim to write 2 thoughts a week on this online journal: probably on a Sunday and a Thursday. I’ve absolutely no clue how long this’ll last, but we’ll see how it goes. As always, any feedback or comments are always appreciated!

This is Water

This is Water

In 2005, David Foster Wallace gave a commencement speech to the graduating class at Kenyon College (the full transcript can be found here). He begins with a parable:

There are these two young fish swimming along, and they happen to meet an older fish swimming the other way, who nods at them and says, “Morning, boys. How’s the water?” And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes, “What the hell is water?”


I have to admit, I had a pretty comfortable childhood. I always had food at the table, a bed to sleep on and family members who truly cared for my wellbeing. However, as a payment for this comfort, I also quietly accepted all the narratives whispered to me. From social narratives of traditional education to more esoteric narratives of Christian doctrines, I never really put much effort into shaping my own values or beliefs. They were just kind of given to me, and I quietly conformed.

Recently though, I’ve begun questioning some of these narratives. While I was lucky to have been raised with high moral principles, I do wonder how many of these I’ve accepted unconsciously and require re-examining. For instance, doing Biomedicine showed me that I really don’t know as much as I think – an idea which crushed a narrative I’d held for a long time. This narrative was built up on 18 years of flowery pampering and breaking this illusion hurt quite a lot.

But while the process of re-examining narratives may be uncomfortable, avoiding this would be surrendering to a state of unconsciousness, a default setting: a cost I feel is simply too great. And so, I’ve decided to embark on the strange new journey of trying to be more conscious and alive. Where this will end up, and what the first step is, I don’t really know. But I guess that’s part of the journey.

David Foster Wallace ends his speech with a challenge:

It is about the real value of a real education, which has almost nothing to do with knowledge, and everything to do with simple awareness; awareness of what is so real and essential, so hidden in plain sight all around us, all the time, that we have to keep reminding ourselves over and over:

“This is water.”

Lockdown

Lockdown

A poem I’ve read several times this past week.

Lockdown

Yes there is fear.
Yes there is isolation.
Yes there is panic buying.
Yes there is sickness.
Yes there is even death.
But,
They say that in Wuhan after so many years of noise
You can hear the birds again.
They say that after just a few weeks of quiet
The sky is no longer thick with fumes
But blue and grey and clear.
They say that in the streets of Assisi
People are singing to each other
across the empty squares,
keeping their windows open
so that those who are alone
may hear the sounds of family around them.
They say that a hotel in the West of Ireland
Is offering free meals and delivery to the housebound.
Today a young woman I know
is busy spreading fliers with her number
through the neighbourhood
So that the elders may have someone to call on.
Today Churches, Synagogues, Mosques and Temples
are preparing to welcome
and shelter the homeless, the sick, the weary
All over the world people are slowing down and reflecting
All over the world people are looking at their neighbours in a new way
All over the world people are waking up to a new reality
To how big we really are.
To how little control we really have.
To what really matters.
To Love.
So we pray and we remember that
Yes there is fear.
But there does not have to be hate.
Yes there is isolation.
But there does not have to be loneliness.
Yes there is panic buying.
But there does not have to be meanness.
Yes there is sickness.
But there does not have to be disease of the soul
Yes there is even death.
But there can always be a rebirth of love.
Wake to the choices you make as to how to live now.
Today, breathe.
Listen, behind the factory noises of your panic
The birds are singing again
The sky is clearing,
Spring is coming,
And we are always encompassed by Love.
Open the windows of your soul
And though you may not be able
to touch across the empty square,
Sing.

Courtesy of Richard Hendrick, a friar in the Roman Catholic order.

COVID Chaos

COVID Chaos

These days, it seems like every conversation involves the recent coronavirus outbreak and its ramifications on society. Whether it’s the toilet paper shortages, job losses or the shutting down of schools and sporting events, a single word comes to mind when reflecting on the last few weeks: chaos. In light of this, I’ve decided to do some research on what’s been happening and reflect on some of the thoughts COVID-19 has brought on over the last few weeks.

Background

  • Coronaviruses are a family of viruses causing diseases with variable virulence, ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). SERS and MERS outbreaks have occurred in the past.
  • December 2019: Reports of a new coronavirus outbreak emerge in Wuhan, China. This virus has been named SARS-CoV-2, with the disease it causes called Coronavirus disease 19 (COVID-19). Compared to SARS or MERS, COVID-19 spreads more efficiently between people to people but has a lower mortality rate.
  • March 11: The World Health Organisation (WHO) declares COVID-19 a pandemic.
  • March 12: The Australian Federal Government unveils its $17.6 billion stimulus package, targeting mostly businesses and welfare recipients. Italy goes into lockdown.
  • March 16: The Australian Federal Government places a ban on non-essential gatherings of more than 500 people to prevent the spread of COVID-19. Events such as the Australian Grand Prix and spectators for cricket games are cancelled.

Present (as of March 22)

  • In Australia, there are currently 1,072 cases reported, though this number is thought to be underreported and will almost certainly rise.
  • Worldwide, 307,652 cases have been reported across 188 countries and territories. Of these, 95,797 have recovered and 13,051 have died – a mortality rate of around 4.2%. The top 3 affected countries are China, Italy and Spain.
    • Live statistics can be found here.
  • While most people recover from the disease naturally, the mortality rate increases for the elderly, the immunocompromised and those with underlying illnesses such as diabetes, heart disease or cancer.
  • Many countries across the world have put restrictions on social gatherings in order to ‘flatten the curve’, preventing an overwhelm of the healthcare system and to provide time for research to develop treatments. The mathematical models assessing the impact of non-pharmaceutical interventions on COVID-19 mortality can be found here.
  • The Victorian State Government has announced shutdown of all non-essential activity across Victoria, commencing this coming Tuesday (March 24).

Future

  • There is currently no well-established estimate as to when COVID-19 will peak or end, though concerns that the outbreak will coincide with flu season in August have led to the push of the influenza vaccine.
  • The International Labour Organization (ILO) estimates that COVID-19 could claim up to 24.7 million jobs worldwide.
  • Trials for a COVID-19 treatment are currently underway in labs globally, though a vaccine will take at least an year to develop, given the time required for pre-clinical development, phase 1 clinical trials and upscaling.  
  • With SARS-CoV-2 accumulating 1 to 2 mutations per month, researchers are drawing up phylogenic trees to put together distinct lineages and gauge its spread. It’s currently unclear how exactly these mutations affect the behaviour of the virus.

3 Thoughts

1. Variable Responses

How does one respond when a safe and predictable week suddenly gets turned on its head due to a virus outbreak that’s taking over the world? The spectrum of responses is amazing, from people simply enjoying the show to others fighting over toilet paper. While it’s understandable that there would be a dramatic response to the pandemic, it’s unfortunate to see unhelpful attitudes such as xenophobia rearing their heads, only adding fire to the chaos.

Perhaps this period can illustrate where one’s priorities lie. For those who are concerned about their own wellbeing, xenophobia isn’t a surprising reaction – this is the perhaps one of the most unstabilising events of the last century and being weary of others is normal. But for those whose concern involves the wellbeing of others, a rare and selfless nature can emerge in a time where looking out for one’s self is the norm.

I’ve noticed it’s difficult to find posts regarding the few benefits COVID-19 has brought about. The media seems to focus exceedingly on new policies, new restrictions and new death toll updates. Very few seem to report that greenhouse gases are at an all-time low. That skies in Wuhan are blue and clear. That the sound of birds, previously deafened by the noise of city noise, now sing out through the silence. That while this time can seem incredibly isolating, it has the possibility to be wholly uniting, as people become increasingly aware of their actions on others. If this translates to more empathy and understanding of others in the future, I think that’s something we can all rejoice about.

2. Default Habits

Crisis doesn’t change people; it reveals them.

Eric Walters

If there’s one thing that COVID-19 helps reveal, it’s our default habits. When the structures and expectations that set up a week collapse, do we still maintain our usual habits and routines or do we turn to other activities, ones which seem more enjoyable and meaningful than our usual work?

Personally, I noticed that my motivations for studying drop immensely when lectures and tutorials aren’t in person. There’s something about being physically present in a class or lecture hall that creates a sense of accountability – something that makes me think, ‘hmm, maybe I should be as studious as the rest of my cohort…’ And that gets me over the line to study. Perhaps this disinterest in studying is a warning sign that my motivations for medicine aren’t as strong as I once imagined, but that’s a thought for another time.

3. Physical vs Social Isolation

I sometimes fear that maintaining physical health through social isolation neglects another piece of wellbeing: mental health. I identify as fairly introverted, but the notion of socially isolating myself for a few weeks doesn’t sound too appealing. Without social interaction, dangerous states such as loneliness can seep in and easily lead to other, more destructive thoughts.

For the majority of people who are more extraverted than myself, I pray people will still interact with and support others during these isolating times. Honestly, ‘social isolation’ should be renamed ‘physical isolation’, since it’s the only the physical aspect of meeting which is dangerous, not the social. Indeed, to fully socially isolate from others would be dangerous, perhaps more so than the virus itself.

As the pandemic situation progresses, only God knows what will happen to us all. But if we remember to add some empathy, some awareness and some kindness each day, I trust we can all get through this together in one piece.

Just Showing Up

Just Showing Up

As I’m writing this, there’s a bit of a problem. The problem is as follows:

  1. I need to post something here once a week by Sunday,
  2. This week, I’ve started writing 3 reflections but am nowhere near close to finishing any of them,
  3. It’s 11:44pm on Sunday and I’m tired.

A part of me grumbles:

Look Eric, you’ve had a long day, you need to get up early tomorrow and no one will care if you post on a Monday instead of a Sunday. Forget this – just go to bed.

However, here I am writing this short thought anyway. Over the last few years, I’ve learnt that just showing up can put big steps forward in achieving particular goals. It doesn’t really matter how the actual ‘session’ goes, but the act of showing up does something incredible: it builds a sense of consistency, which in turn gives evidence for becoming a particular type of person to do a particular action again: a positive feedback loop, in a sense. To put it in clearer terms, here’s James Clear on the topic:

Every action you take is a vote for the type of person you wish to become. If you finish a book, then perhaps you are the type of person who likes reading. If you go to the gym, then perhaps you are the type of person who likes exercise. If you practice playing the guitar, perhaps you are the type of person who likes music. Each habit is like a suggestion: “Hey, maybe this is who I am.”

No single instance will transform your beliefs, but as the votes build up, so does the evidence of your new identity. This is one reason why meaningful change does not require radical change. Small habits can make a meaningful difference by providing evidence of a new identity. And if a change is meaningful, it actually is big. That’s the paradox of making small improvements.

Source: James Clear

Personally, I’ve found this to be true. I mean, I barely ever go to the gym so being a ‘buff guy’ is a title I would never consider claiming – I have no experience of lifting to show for it. However, showing up for the tasks I do perform gives a ‘vote’ for the type of person my actions embody. If I clean my room, I ‘vote’ for being a tidy person. If I get up early for a run, I ‘vote’ for being a runner. And when I stick to my self-allocated writing schedule, I ‘vote’ for being a person who sticks to their word. Even though these thought patterns can be unhelpful, I find them difficult to avoid and I suspect other people have similar tendencies as well.

But crucially, the converse is also true: when I don’t show up for such actions, or take unproductive actions, it gives a small ‘vote’ against the person I would like to become. For example, I’ve recently been rocking up to class late various times these last few weeks – one of the dangers of living close to Uni. Now when I leave to go to class, I almost habitually push how long I can wait until I’m too late, as I’ve ‘voted’ for myself as being a late person. Of course, this is an unproductive and rude characteristic to have, but due to my past votes for this identity, I’ve struggled to break out of this thought pattern. This means that any productive tasks done consistently have substantial carry-forward effects whilst unhealthy, habitual tasks have similarly powerful but destructive effects, reiterating the simple importance of just showing up.

11:59pm. Alright – time to sleep.

The Art of Empathy

The Art of Empathy

Note: All the names below have been changed for confidentiality. Any resemblance to persons as a result of these changes is entirely coincidental and unintentional.

“God, all I want to do is to be healthy again. This sore throat, tight chest, breathing problem, it’s slowly taking over my life. I’ve been to seven different GPs and they’ve all just given me more pills but they make me feel worse! I honestly don’t know what to do… I can’t keep living like this anymore.”

My mind begins to whirl, processing the information as I think about what I should do. Dyspnoea (shortness of breath) could be due to cardiovascular or respiratory causes. Should I ask about coughing to clarify this? Or ask about her past medical history to get a better understanding on what’s going on?

These thoughts are running through my head as I sit in the corner of a small room, amongst three others. It’s my first day on GP placement and I’m currently sitting in the middle of a consultation as a first-year medical student, where my role is to simply observe. In front of me is my supervising GP Dr. M, as well as a young French couple. A few weeks ago, Daphne (the patient), immigrated to Australia from France, ready to start a new life with her partner. However, as soon as she arrived, she developed chest pains, a sore throat and trouble breathing which have worsened over time despite various medical interventions, eventually leading her to us.

I sit quietly and wonder how Dr. M will respond. Seconds pass and to my surprise, Dr. M simply sits facing Daphne quietly, prompting her to continue. A stiff silence emerges and begins to grow, until Daphne breaks it.

“Please don’t give me any more pills… I really can’t keep living like this anymore.”

Daphne breaks down and the room now fills with quiet sobbing. I turn to stare at Daphne’s bursting bag of prescriptions on Dr. M’s desk – a menacing bag, one only weighing a few hundred grams, but carrying heavy connotations of sickness and vulnerability. The silence begins to grow again until finally, after what seems like an eternity, Dr. M stirs. And what happens next I can’t describe as anything but magic.

It starts off with a recognition of the pain that Daphne has gone through – a simple nod, an apology for the trouble that the supposed ‘treatments’ have caused her. “It must be very difficult for you,” Dr. M gently expresses. “To come to a new country hoping for a new life, only to be met with illness.” Teary-eyed Daphne looks up, surprised. “I only came to Australia a few years ago myself,” Dr. M continues. “So I can relate to some of the stress you’re feeling now.”

The tension in the room immediately dissipates. Daphne sits a little straighter and leans a little closer to Dr. M as the questions start coming out. They talk, not just as a doctor and patient, but as fellow people. People with stories unique to themselves, but with surprising and beautiful similarities to others. As Daphne’s explanations become more detailed and emotive, I wonder if this is the first time she truly feels heard. After a few questions (including, to my satisfaction, coughing and past family history), a few examinations and many explanations, a treatment plan for Daphne’s illness is transpired, with clear instructions to come back if the symptoms don’t get better. Daphne looks relieved and I can see a glimmer of hope in her partner’s face.

As Daphne and her partner get up to leave, Daphne turns to me. “I hope you become a doctor like this when you grow up.” I nod and smile in response as they leave the room.

Aftermath

“You know Dr. M, the way you approached the start kind of surprised me. I thought you’d go straight into asking history questions.”

Dr. M smiles as I ask the question but doesn’t stop typing up her consultation notes on the computer. After a few seconds, she turns and addresses me.

“Sometimes, the best thing you can do for a patient isn’t to ask more questions. Often, just being with them, giving them the space to speak and recognising the pain they’re going through goes an incredibly long way. It’s something they don’t really teach you in medical school – the art of empathy.”

Later that day, I think back to my default response to Daphne’s presenting problems. How eager was I to get to the underlying cause of her problems whilst giving Daphne herself no thought? How many of her previous GPs had done the same and caused more harm than good? The art of empathy: by no means an easy or decorated practice, but one which is crucially important. It seems that ancient adage finally makes sense: Treat the patient, not the disease.

Dunning-Kruger Cycles

Dunning-Kruger Cycles

In the middle of Year 9, I failed my first exam. It was for chemistry and having never failed an exam before, this came as a huge shock and I remember staring down at the number on my paper, stunned. Then reality hit and a disturbing thought crept into my mind: maybe I’m not as smart as I thought.

This chemistry exam forced my perceptions of cognitive ability to be re-evaluated. Before the exam, I held a fairly steady academic record, being a straight A student and achieving Dux of my primary school. Scoring above the class average was expected of me, by both everyone around me and myself.

But perhaps this steady academic record was what got me into trouble. In the days leading up to this chemistry exam, I wrote in my journal,

I really haven’t studied that much for this chem exam… but I’ll be fine right? Chem isn’t that hard. Lol.

Look, I was in Year 9

Instead of reflecting on my study techniques and work ethic that got me to this place, perhaps I let my academic standing get to my head. You’re smart enough. I might’ve whispered. Look at your exam history – you don’t need to study for this.

The Dunning-Kruger effect: a cognitive bias in which people assess their cognitive ability as greater than it is. It largely stems from both an overestimation of their abilities and a failure to recognise any lack in ability.

In the moments before the chemistry exam, I’ll call the state I was in as ‘Dunning-Kruger positive’, whereby my cognitive abilities were heavily overstated, even delusional. Directly after the chemistry exam, I’ll call the state ‘Dunning-Kruger negative’, whereby my cognitive limits are reflected upon and re-evaluated.

This exam begun a series of Dunning-Kruger cycles, in which ‘Dunning-Kruger positive’ and ‘negative’ states came and went. After the chemistry exam came a series of successful assessments, which unfortunately lead to a replacement of solid study habits with arrogance, a ‘positive’ state. Soon after, I began my Biomedicine degree in University and began performing poorly there, transitioning back from a ‘positive’ to a ‘negative’ state. Right now, having started medicine and realising how little I know versus what I need to know, I’m well and truly in the ‘negative’. However, this time I wonder if I’ll ever feel like I’ll come back to a ‘positive’, given the complexity of medicine.

Sometimes it’s easy to forget how we got to the places we are now. We misconstrue our history, ignoring key moments and forging erroneous causes. Was I smart in Year 9? Maybe, but it was definitely by no inherent means. Rather, it was through the hard work of my parents to fund my secondary education, who gave me opportunities to pursue extra-curriculars and who supported me through every step. Rather, it was through the teachers who inspired me to learn and guided my academic adolescence. Rather, it was through God, the creator of heaven and Earth, who gave the greatest privilege of life. To ignore these factors would not just be arrogant, but pathologically delusional.

This serves as a reminder for me to continuously reflect on my limitations and earnestly pray to overcome them. While there will almost certainly be times where I drift back to an arrogant state, I hope I’ll be able to recognize this and reassess my limitations – before I fail another exam, or worse.

Shifting Perceptions

Shifting Perceptions

“So, the next step in the history taking process is to define the pain. You start this by asking for site, with questions like, “Where are you experiencing the pain? Can you pinpoint the site or is it more general? Does the pain radiate (spread anywhere)?” And if the pain is on one side of the body, remember to ask about the other side – this is important. Got it? Okay, the next step is severity…”

As the tutor speaks, the flurry of medical students typing notes is oddly reminiscent of a waterfall, with myself and 11 other first year medical students taking part in its creation. The class I’m in is called Clinical Skills Tutorial (CST), which teaches the more practical skills of medicine such as taking histories or doing patient examinations – this week, we are being introduced to the history taking process. But while it is exciting to learn what a doctor does, I can’t help but feel a different, uninspiring feeling rise up within me as I type. A twinge of… disappointment. The disappointment initially surprises me but after a while, it fades away. I soon realise why.  

When I was little, I thought doctors were a special breed of people – those blessed with levels of intellect, observation and analytical thinking far beyond that of the general population. A ‘superhuman’, if you’d like. I always marvelled how a GP, upon never seeing a patient before, could diagnose the cause of chest pain using a few questions, tests and some poking around and then prescribe the perfect drug, where the patient would then live happily ever after (hooray!). I imagined doctors had flashes of superhuman genius which told them what questions to ask, what diagnoses to make and what decisions to make in critical situations – a process mere humans could never understand.

But of course, doctors are human and have limitations like the rest of us. Doctors often get things wrong, with diagnostic error rates estimated to be close to an alarming 15% [1]. And from my first few weeks of medical school, it seems unlikely that wild ‘flashes of inspiration’ occur at all. Rather, medicine seems more mundane, more formulaic – a process of extracting the same pieces of information from each patient and recognising particular groups of symptoms. Almost like pattern recognition, like a game. Nothing too superhuman at all.

It’s somewhat disappointing to reach the conclusion that doctors probably aren’t too different from the rest of the population. I imagine the notion of the ‘superhuman doctor’ is something we hold for our own sake – we want doctors to be infallible, incapable of getting our diagnoses wrong, when in fact doctors can get sick, miss their families and become exhausted just like the rest of us. Despite all this, the ordinary doctor tries their best to repair a patient, knowing full well that they share the same limitations of energy, time and need for social connection.

But perhaps it is exactly this that makes doctors and other allied health workers superhuman: the constant exertion of effort to reach an unattainable level of perfection for the sake of the poor, the injured and the broken. It’s taking potential burnout, imposter syndrome and unmet social commitments and temporarily moving them aside to make space for the patient’s needs. Caring: perhaps this is what makes healthcare workers superhuman – not some transcendence of IQ or memory, but something more subtle, more internal: the prioritisation of others’ needs above your own. Now that is pretty extraordinary.


Sources:
1. Graber ML. The incidence of diagnostic error in medicine. BMJ Quality and Safety. 2013 Oct; 22(Suppl 2): ii21-ii27.