What is your metric of success?



How do you judge if you are doing well or poorly? How do you know if you need to change something? How do you decide what the right course of action is? Is it the feedback from your boss? The surveys from customers? The smiles of patients? The profits that come in? The respect of those who are important to you? Most people, including myself, cannot provide a logical and concise answer to this. In reality for most of us the answer is probably yes… all of the above. We take surveys, feedback, smiles, profit, and respect, run those past the internal compass of who we are are and what we believe to be important, and then judge ourselves based on that.

The third year of medical school is the first clinical year. The first year in the clinic and thus the year at the bottom of the hierarchy. In medicine, as with many other fields, things can be right for two reasons: One, there could be empiric evidence supporting the fact, or Two, there is no empiric evidence but only the preference or dearly held belief of someone higher up the ladder. The point of education is to gain the first and disregard the second without damaging the tender egos above. Reading Ayn Rand (The Fountainhead and Atlas Shrugged) while in this environment is simultaneously amusing, ironic, and bewildering. Yet it also is centering. Although Rand’s ideas are not all correct, the radical juxtaposition of her ideals and modern medical education is enlightening. It highlights what aspect of the education that really matters, in this case excellence in evidence based medical practice and a deep personal enjoyment of the work, and what does not matter at all, in this case petty arguments,  myopic practitioners, and patients who refuse to take responsibility for their own health.

So whether the field be medicine, law, business, or any other field, slowly yet intentionally developing a base of empiric evidence and discovering a personal pleasure in the task is the most important method of judging success. Everything else, feedback, surveys, and profits are superfluous and peripheral if they do not align with first two.

A simple guide


Everyone is constantly offering their advice and their opinion about how you should act. And no matter how strongly stated, it is just that- their opinion. People can be displeased with you. Scratch that. People WILL be displeased with you. There’s no avoiding that. But very few people, far less than we imagine, can actually impact our lives in a significant and negative way if we do not let them. Reading biographies of successful people, they all had habits, opinions, and preferences, many of which do not align and often contradict. Elon Musk has mentioned on several occasions how rude Steve Jobs was to him when they met. Even beyond the obvious competition within the computer industry, the personal lives and habits of Steve Jobs and Bill Gates could not be farther apart. George Washington and Alexander Hamilton had a dramatic falling out after many years working together closely. Even Lewis and Clark strongly disagreed at points in their famous journey. Some people tell you to be deferential and mind your place, other urge you to be bold and to make your presence known. Some are all about book knowledge (most great people have been voracious readers), while others count on experiences to teach them all they need to know. People who have done well have opinions. People who have done poorly have opinions. People who have no idea what they are talking about still have opinions. Many people think your goal in life should be to become just like them. Others just assume that your goal has to be the same goal as theirs’.  

I realize the irony in prefacing my advice with an argument that we should discard many of the opinions of others. So instead, consider this as guidelines for myself, should I lose my way in the sea of voices:

Approach every new endeavor with curiosity, interested and ready to learn new things. Allow experiences to change you but hold tight to the core of who you are. Work hard with a tenacity and a resilience that few can match. Be humble with your head up and your shoulders back. And finally, be grateful for the opportunities and the people around you.

Confession and Gratitude


For every apology, for every confession, for every step of repentance, there must be an equal amount of gratitude and thanksgiving. With only confession the Christian recognizes the woeful inadequacies that drive us to the bottom of the pit. Without thankfulness for what He has done in our place we stay within the pit and slowly dig deeper without seeing reprieve or hope. With only thankfulness we are not able to fully articulate and celebrate that for which we should be grateful. Without confession for what we have done, we fail to see that on an hourly or minutely basis we willingly choose to jump back into the pit and cannot fully see to what extent we should be grateful. These two work together, linked to show us simultaneously our depravity and his grace so that we are neither crush beneath the weight of our failings nor inflated to subscribe to a hope in our self-sufficiency.

Virtual bubble


While the internet has connected us in many ways, it has also made it much easier for us to find and congregate with people who agree with our ideas and our opinions.  We carefully curate our social media feeds and populate them with people who are often very similar to ourselves. The social media companies suggest material, advertisements, and friends that they think best match us. And they certainly do not present us with people or ideas with which they think we will dislike and disagree. Often we don’t even see this when it is happening. Take the last election cycle. Many people were amazed that Trump won. Within many liberal, urban centers there was a sense of shock at the results of the election. In academia, which now is broadly notorious for the liberal skew, many people couldn’t name many friends or peers who would vote for Trump. Everyone’s feed from Twitter or Facebook is an extremely poor representation of the larger population on nearly every topic. Instead of promoting diversity of thought and diversity of opinion, some areas of the internet have enabled a paucity of thought and a clustering of yes men (or women) who congregate in the same virtual areas. Perhaps even worse, when we do encounter the ideas and opinions of people with whom we disagree online, this is a caricature of the whole person and the method of communication is starkly one dimensional without many rules, non-verbal cues, or incentives to be courteous and give the person the benefit of the doubt. I still have yet to meet someone who got in a battle over Twitter or Facebook and who was won over through the sound reasoning and convincing rhetoric of the other side.

So find friends, online or offline who disagree with you. In the words of Thomas Jefferson, “I never considered a difference of opinion in politics, in religion, in philosophy, as a cause for withdrawing from a friend.” As much of our lives now involve some aspect of internet based technology, so the bubble we are has enclosed this space as well. In a digital age that pushes us away from people unlike ourselves, this becomes a task in which we must be constantly intentional. Both offline and online engaging with real people with ideas and beliefs different from ourselves is not an accident. It must become a habit critical to our growth and our identity as citizens of the global community.