How successful you feel is often more about how you define success than it’s about what you’ve achieved.
I learned that early on in my medical career. Like most medical students, I saw medicine in terms of the ability to work out a cure for whatever ailed people. I still see that in the medical students I get to teach on their psychiatry posting, both back in Nigeria and here in the UK. In fact, those among them who are less keen on psychiatry as a possible specialty often give their reason as the perception that people with mental illness don’t get better.
It’s a deeply mistaken perception, of course, but underlying it is the idea that cures should be possible. And in psychiatry, thinking in terms of “cures” isn’t that useful.
And this might surprise you, but I believe that’s a good thing.
To be clear, I don’t mean that wanting to achieve an outcome is a bad thing. Part of our being human is that we’re less driven when we don’t have something to reach for. We need goals, something to mark our success in whatever we’re working at. Something to encourage us to keep at it even if it’s hard. And even succeeding in something small is enough to keep us pursuing a bigger, harder goal.
But just as important as a sense of success is that we are not chasing unhelpful ends. It’s like the old idea from business management about being careful not to climb to the top of a ladder only to realise we’ve climbed the wrong ladder.
In my second year as a fully licensed medical doctor, I worked in a clinic where we saw many patients with conditions like sickle cell disease, rheumatoid arthritis and all kinds of cancers. But that led me to notice how, besides infections (and not even all of them), a lot of health problems were not curable. Hypertension, diabetes, autoimmune disorders, degenerative diseases, all kinds of disabilities, to name just a few. All conditions people must learn to live with, not the kind they can get rid of.
If I continued to view success with them as achieving a cure, then I might as well have resigned myself to failure.
So I redefined success: instead of defining it as achieving a cure, I started to think about it as making their life better.
That alone shifted success with my patients from something only occasionally possible to something that could happen every single time. 100% success rate instantly became possible.
It’s not just semantics, either.
Apart from the very real way this makes success feel achievable (which is massively important), I came to find this was more closely aligned with what people wanted. Everything involves tradeoffs, in medicine and in life, and cures are no exception. And defining success in terms of a cure can easily lead to ignoring the specific things most important to people.
That’s why people will sometimes decline what doctors consider the best options: they’re not being irrational. They’re in fact, being very rational: we are just not seeing their full frame of reference.
Changing how I define success brings that frame of reference into view. The question, “How can I make life better for this person?” is one that we can’t answer without the person. It transforms the encounter into an active dialogue in a way that just wanting to fix things can’t necessarily produce.
In the same way you might be feeling rubbish about your life and achievements, and that’s valid. Maybe there’s things you want that you haven’t gotten. And maybe those things really are important, just like curing a disease is an amazing thing when it’s possible. But the cure is not the only valid endpoint, and where it’s impossible, there’s any number of other endpoints that are no less important.
And that’s the point about redefining success.
It’s not semantics, or trying to claim some kind of consolation prize. No, it’s not that at all. It’s about the very practical reality that there are often multiple desirable endpoints, and we do ourselves a disservice when we assume only one endpoint is valid.
Where might you be needing to redefine “success”?
Looking for possible way out to help a patient might end up being the best medicine ‘cos care and concern at times serve as means of health improvement.This write up vividly reminds me of placebo treatment.