I will like to continue on the blog I started yesterday on the response of Atul Gawande to the question about why he left the politics of being a policy wonk in the White House to return to medical school and take up surgery.
“I wanted to be less dependent on the fortunes of others in making my own career; I wanted to be able to develop and voice my own ideas. And then there was this desire to have some skill besides just being at the abstract level of policy and work at that level. So I returned to medical school instead of taking up the offer to work on welfare reform.”
He went on to say about surgery, “I loved the sense of skill. And it reminded me of politics in some way – that the really good surgeons had to be like really good politicians in being willing to take chances, deal with risk, know that your knowledge and your skills are uncertain.”
Of skill to do
“There was this desire to have some skill besides just being at the abstract level of policy and work at that level…” Here, it is apparent that Atul Gawande had to make some serious life-changing and career-defining decisions. Whilst he did not knock the idea of being involved in policy making, he realised he needed to have other skills such that when the need for policy derived from his being dependent on the fortunes of others dried up, he will still be fully able to chart his own course.
It is also quite revealing for him to suggest that policy work was quite abstract rather than practical, even though policy has a way of affecting people’s lives. Yet, it was clear that if he had stayed, he still had ample opportunity within that political setting to be involved in welfare reform.
“I loved the sense of skill…” Yet, in leaving policy work for medical school and specialising in surgery, he had found a new vocation and calling, a sense of skill that went well beyond the abstract.
The excitement in the sense of skill is captured in his applying his acquired policy knowledge to his growing medical skill that he found ways to conflate politics and surgery in the following response.
Of chance and risk
“It reminded me of politics in some way – that the really good surgeons had to be like really good politicians in being willing to take chances, deal with risk, know that your knowledge and your skills are uncertain…” In essence, no knowledge in all his fields of endeavour was lost, rather the whole body of knowledge had become uniquely his own experience.
This experience is what now allowed him to understand the similarities between good politicians and good surgeons, and one might even say any profession where ability, skill, expertise and experience matters.
For we all have to be willing to take chances where there choices are not as obvious or the course is uncertain. In that, there is risk, some calculable and in other cases quite unquantifiable that is becomes somewhat adventurous, because from another viewpoint, noting ventured is nothing gained.
Knowing the uncertainty of skill
Many of us may be risk-averse, but without understanding risk and exploring the possibilities beyond what we know for certain, we risk living unproductive, mundane and boring lives with sadly unpromising careers to boot.
In all this is the ultimate lesson of knowledge and wisdom, that is to know what you know and what your skills can achieve whilst being very cognisant of the limitations of your knowledge and beyond attempting to bluff your way past issues where you have no ideas, you are geared to learn, to research, to reach and to extend yourself to acquire new knowledge and chart new courses.
The awareness of the fact that our skills even when well-honed might be uncertain to dealing with particular situations that we might have to adapt or withdraw to reflect and relearn is one of the greatest gifts of self-development.
Having worked in the Information Technology industry for about 28 years, I am well aware of the limitations of my skills, however, more importantly is the fact that I do not always have the answers or solutions to problems or challenges to hand.
In many cases, the knowledge to tackle an issue has only come from being presented with a particular situation that requires a resolution and since not all situations are the same, the solutions will differ.
Yet, all this knowledge becomes part of the body of knowledge uniquely mine that is a subset of my wider experience beyond just my profession and when presented with a similar set of circumstances again, I will probably be better equipped to provide a resolution much quicker than when I first encountered that setting.
I have never feared not knowing, nor have I been held back by not knowing what to do, rather, I have seen such challenges as new opportunities to broaden my knowledge and then return to resolve that conundrum, and doing the next thing. There is excitement is not remaining stagnant, but in pressing on and moving on.
These responses laid the ground for the beginning of the lecture on the subject – Why Do Doctors Fail? [PDF Transcript]
I hope to cover that lecture in some detail in another blog.