A few years back I was in my car driving from Sydney to Canberra, it was raining and cold (a usual story for that part of the world). I couldn’t seem to stop the windows from fogging.
I was churning through podcasts to pass the time. Somewhere along the highway, around Goulburn from memory, one of the podcasts grabbed my attention a little more forcefully than the others. I see now that this was a truly influential experience. Not because of the podcast, but rather because of the book it led me to read and the challenges it posed for me.
The point of today’s post is not to summarise the podcast, nor is it to analyse the book (I will put links to both of these things at the bottom for you). Instead, the point is to discuss a single basic idea they promote. The point of this post is to suggest that the idea below is critical when it comes to a medical education.
Do things that scare you.
The podcast led me to a book called The Flinch, written by Julien Smith. The Flinch is an uncomfortable read, it lays you bare. The words strip away excuses, they expose insecurity and a lack of readiness to abandon comfort. To quote from the first page of the book, “The book is about how to stop flinching. It’s about facing pain”.
The ‘flinch’ that Smith refers to is that innate jump at a scary circumstance. It’s the jump that gets you running away from the lion. Smith asserts that these days our flinches are over-active. That we flinch at harmless things – public speaking, exams, performing in front of your peers or your mentors. In everyday life our flinches are unnecessary and limiting. Some people are affected more than others. The Flinch preaches the need to re-train our innate flinch, to re-calibrate the set-point for a flinch to be warranted, to re-establish what things are actually ‘scary’. To do this, Smith takes us through a series of challenges. He asks us to face some fears.
Opinion: if you have an overactive flinch, taming it down is a must if you plan to make it through med school.
The situation that sticks in my head is week one of clinical teaching at our medical school. To set the scene… You are being told that this next skill is perhaps the most important thing you will do with patients within your career. The clinician emphasises that it is going to take years to get good at this skill and even then, you will make mistakes. You find out that the skill it to take a patient’s history. You think to yourself ‘Geez, how hard could that be?’. Next thing you know you are sitting in a small tutorial room with your classmates. A volunteer patient walks through the door as the tutor asks for a volunteer. FLINCH.
Heart rate starts climbing. Sweaty palms in full swing. Downward spiral of negative thoughts.
There is a fundamental question raised in Smith’s book. Why do harmless things, things like the chance for structured learning and direct feedback that I’ve described above, scare so many of us? And beyond this the book poses the challenge to us. Re-train this ‘habit’ by exposing ourselves to harmless instances of fear and we will benefit. Re-train yourself to remove unnecessary flinches.
As a medical student, fear will shelter you from opportunities, from experience, from feedback and development. Being that person who volunteers to go first provides tremendous benefits.
When facing fears starting small is the key. Smith urges us to consider facing ‘scary’ things with no possible detrimental outcome. He wants you to take a cold shower (managed almost a year of that – Canberra winter got me eventually). He wants you to smash a mug (really? a perfectly good mug? I still flinch when I think about this one). He asks you to speak to a stranger (welcome to every day in medicine for the rest of your life). He wants you to escalate these things appropriately to the point where you are more comfortable, less afraid, more confident.
I attempted to adopt these ideas, along with always having a desire to seek challenges. I did the cold showers for a stint, I smashed the mug (only once), I spoke to strangers repeatedly. I became more comfortable, less afraid, and developed more confidence. I didn’t stop there, I continue to face flinches when I see them. Often I start stripping off for a shower and shudder at the thought of a cold shower. I take this as a sign that the flinch is back and force myself into the icy water. I say yes to all things possible, regardless of a grumbling fear, a racing heart or some sweaty palms. Now when I hear a call for a volunteer I quickly call out “I’ll have a go”. Not because I’m cocky or greedy but because I feel the need to keep the flinch at bay.
I believe that keeping the flinch at bay will lead to opportunities, experience, feedback and development. I believe that we need to find things that scare us and that being brave is about finding those things, having that fear, but doing them anyway.
Be brave, it’ll be worth it.