Thought Picnic: Becoming less dependent on the fortunes of others

An introduction

This is a blog of many blogs I should have written many months ago when I was first inspired, but I have left it until recently as I dithered over the last week on how to start writing.

Dr Atul Gawande gave four lectures for the Reith Lectures in 2014 on The Future of Medicine, the enlightening and interesting things he touched upon about medical practice and personal experiences with medicine and patients made for repeated times of listening in again.

The first lecture was titled, Why Do Doctors Fail? [PDF Transcript], there is much to discuss in this lecture, but I will first concentrate on some answers he gave when he was introduced to the audience.

I will eventually cover the topical issues in further blogs, every doctor and in fact, patients or prospective patients should take the time to read or listen to these lectures.

Some background

Atul Gawande is a typical third-culture-kid, born to Indian medical practitioners in the United States, studied at Stanford University, and was a Rhodes Scholar at the University of Oxford before taking medical degrees at Harvard.

However, before going to Harvard, he was a policy wonk on healthcare for Bill Clinton and was in the White House to help Hillary Clinton on her ill-fated Clinton Health Care Task Force. Being in the deep corridors of power, he could have chosen to stay there among the movers and shakers of America, but he did not.

Sue Lawley, the moderator of the first lecture at the John F. Kennedy Presidential Library and Museum in Boston, having surmised that he had worked for Clinton and gone to Washington, asked why surgery eventually won over politics.

Career independence

Atul Gawande answering many questions in the discussion before the lecture began showed a great sense of self-awareness and purpose.

“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.”

About surgery, he said, “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.”

Daring to chart an uncertain course

“I wanted to be less dependent on the fortunes of others in making my own career …” This profound sense of independence is incumbent on people at the beginning of their careers to comprehend. You need to understand and appreciate where your career is going, how it develops and who it might depend on.

Many for their skills and ability find themselves in positions of privilege and opportunity that they somewhat forget that situations and circumstances might be ephemeral or transient, they get comfortable.

I remember a younger friend who at 29 was about to be made a partner in a global consulting firm, probably the ambition of a majority, it represents the pinnacle of achievement for some, a fulfilment reckoning of accomplishment and achievement. My friend thought at that age, that becoming a partner with its opportunities would create a limiting perspective on his broader career, so he left the firm and embarked on an exciting middle-management career at other global firms.

With politics, nothing is certain either

With politics, there is even less certainty, your position is at the pleasure of the chief or patron, and you can be dismissed on a whim. When your principal ends their tenure you will likely be out of work too. Recognising this tenuous relationship can be the saviour towards a more fulfilling career.

In my own career, I have rarely been an organisation man, in all the years I have had any kind of employment, I have only been a full-time employee for 7 years spread over 4 different jobs in Nigeria, the UK and the Netherlands since 1988.

I began my foray into self-employment and consultancy in Nigeria after a year of being fully employed and wading into the uncertainty of the market but assured by the certainty of my skills and knowledge that I could not only dictate my terms but also reap huge rewards for choosing to be different.

This has served me well since July 1995 when I first went contracting in the UK, but for a 2-year stint of full employment in the Netherlands and when I had cancer through treatment and recuperation.

My fortunes have mainly been borne of my knowledge and instinct, skills I have acquired through self-motivation and ambition that have taken me into blue-chip companies around Europe proffering ideas and solutions to their challenges, both little and large.

To voice my own ideas

“I wanted to be able to develop and voice my own ideas.” There is every pleasure in having a mentor, in life and in your career, I have had quite a few and I cherish them. Most especially, I had John Coll who passed away last year. I was never his employee as I did not have the skills he needed in his organisation, he was always there to provide guidance, encouragement, advice and the steeling up I needed whenever my confidence was lacking.

More particularly, even when he first helped me redraft my resume in mid-1994 he was quite particular that it was written in my voice and my kind of thinking since I will be the one to defend it when at interview. I was offered a new job on that new marketing literature within weeks of publishing it.

Develop yourself as you

There are uses of patronage and the peddling of influence, but one must maintain a sense of independence of thought and voice with the ability to fearlessly convey those views. I can say that in my career, either as a contractor or a full-time employee, I have always been a good communicator of my views, some will say I am quite strong-willed, maybe I am.

Rather than being obsequious to your principal, I am of the view that if your views are forthright, sensible, reasonable, honest and clear, you will be of great benefit to all that you engage with, earning the respect of those around you even if you are disliked for your autonomy.

There is no pleasure in being a clone or a parrot, a poor imitation of the real thing schooled in the required talking points and jargon, acting to a set script in robotic obeisance and necessity, all in the quest to be appreciated and to belong.

It is so false, boring and quite unedifying in the long run. You eventually lose who you are and become a non-descript personality only differentiated by appearance and nothing else.

There is much else to mine in those quoted responses, but let’s start with this.

Extricate yourself from following others so close that you can’t cut loose when you need to, that you go down with them, if and when they do.