Neuroscience Recipes: Mixing the Ingredients and Competition

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February 1, 2007
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Recipe for Neuroscience: New Ingredients, Competition and the Medical Game

An interesting phenomenon persists in the evolution of applied neuroscience: Competition

We all now know that competitive and imperious medical school professors breed competitive, negative and disrespectful physicians. Years ago team play in medicine didn't enter anyone's mind. The traditional management system was vertical, in keeping with social norms, and the history of science back to Aristotle [see Korzybski for a comprehensive review on the history of science and thinking]. The old message: “I am the enlightened one, you are the novitiate.” This attitude persists in some dark corners of medical education and practice today, and, oddly, in the field of neuroscience.

We want compassion and care, we breed stealth warriors.

Let's think about this:

Physicians are often trained as prairie fighters. Run the gauntlet of medical school and residency and you could have your own personal feudal domain, your own sweat lodge. The outcome: wounded warrior docs out there in the Transvaal of life with a mission to seek competitive advantage over their colleagues and their patients.  Kill the competition.

Subtheme: Save the tribe through personal victory over those insufficiently trained [read “stupid”] other docs. Disrespect, imperious behavior and undercutting colleagues is still pandemic. It is the warrior code: Don't talk, just shut up and do it.

Enter managed care. We will manage you if you can't manage yourselves.

So, what do we do about this challenging mix?
Let's get into the underlying process and change our medical recipes through:

    Use of all available information,
    Practice a scientific mix of these new ingredients,

    …..And change the way we play the game.

Let's take a lesson from the most successful squash coach in the nation: Coach Peter Briggs at the highly esteemed Wapawamis [really] Club in Rye, NY.

In Forbes an excellent article by John Sedgwick, on “The Briggsian Coaching Philosophy” discusses an essential perspective for world class squash, and world class medicine:

The Briggs/Wapawamis Credo:
1. Ability is what you are capable of doing.
2. Motivation determines what you do.
3. Attitude determines how well you do it.

Attitude correction can encourage our evolution in neuroscience and medicine.
Says Sedgwick after some Briggs coaching on his own game:

“It wasn't so much about strokes and particular placements as about angles, curves, parallels and quadrants – a kind of Euclideanism [solid, 3-dimensional geometry vs plane geometry] that lies at the guts of the gutsy, hard driving sport…. It was an attitude I got from Briggs, one he inherited from his Harvard coach, Jack Barnaby…you owe it to your opponent to try hard, to dig out each point, to lay it all on the line…. a strangely non-competitive vision of competition: squash players united in service to this demanding game, and through it, to each other. You are there to bring out the best in your opponent to bring out the best in yourself. Triumph requires selflessness; we win by loosing ourselves. On the court, as off it, we are all in this together.”

And so it is with medicine, with our colleagues and our patients.

We are all in this together.
Care and compassion mix better with selflessness.
There is no medical ego, there is only ego.
Compassionate attitude is solid, geometrically and operationally.

Next post: remarks on the interesting dichotomy between innovation and practice.

Please drop a comment if you have any thoughts on this subject or the article by  Sedgwick.

cp

4 Comments

  1. Hal-
    Thanks for your remarks. With some, like yourself, I know I am preaching to the choir. With others just now knocking on the door of change, the squash coach may help consider the evolution of the real game.

    So much information in the evolution of neuroscience we all have to play ball together as none of us can get it all in one lifetime.

    Chuck

  2. Dr. Hal says:

    Chuck,

    Great blog. Both patients and doctors need to realize the importance of the team, if people are to have good health.

  3. Bea,
    Thanks for the kind remarks all the way from Turkey! It’s a recipe thing-
    Chuck

  4. Bea Vanni says:

    Great title, Dr. P! The old message brings me back to the 70’s with I’m okay, you’re okay and the many iterations of it. I find it more challenging today to find a physician who heals through listening. No listening factor occurs because they are the “enlightened” one and we know nothing about our bodies, even though, we have lived in them for xx number of years. Give me a listener with less competency and I will get someone who will search for answers to the problem and come with a complete solution versus no listening and completely ignoring the problem. Your articles are insightful, so keep them coming!