The Quest for Working Happily Ever After

Heart rate mildly elevated, the sweat glands open, eyes fixated on the task at hand.   Time feels slow – or even frozen – but also at once flies by between each glance of the watch.  It’s an experience termed flow, which has been famously described by Mihalyi Csikszentmihalyi in a book by its namesake.

Flow has many components, but the most easily understood set include challenge and feedback – engaging in a task just sufficiently difficult to the level of ability and knowing immediately whether you did the right thing.

Like Fight Club, the experience was in everyone’s face; Csikszentmihalyi just made it visible.  The experience was on everyone’s tongue, and he just gave it a name.  In fact, it’s an experience so addictive (yes, flow experience and cocaine both use the dopamine pathway) that we sometimes spend the entire first half of our lives seeking that experience which we call a career.

For example, I am a radiology resident, so I spend most my time getting better at interpreting radiologic studies.   I get to enjoy the flow experience that comes with solving cases that are sufficiently difficult but not hopelessly so.  I am also fortunate to be immersed in an environment where my teachers are not just good but are among the world’s best.  Ergo, I want to become a world expert, too.

In a cognitive profession like medicine, we pride ourselves on becoming intuitive diagnosticians.  Everyone wants to be the genius that glances at a chest radiograph and identifies subtle rare manifestation of a rare disease.

But wait, the flow experience only occurs during active engagement of optimal difficulty.  As I become better at, say, MRI of the brain, there will be progressively fewer brain MRIs that would give me the optimal experience.

In fact, if we believed that the flow experience is the only reason to pursue a career, then it follows that we should hope to a terrible radiologist.  After all, most of the studies done in this country are normal, so logically, the professional who is barely able to identify even the most mundane abnormalities would have the highest probability of finding the next case “optimally challenging.”

Ergo, the secret to happiness in radiology is to become terrible radiologists.  No, wait, that can’t be it.

Behavioral psychologists use the dual process theory to explain how experts seem to think faster than computers can – they weren’t thinking at all – System 1 is credited with the genesis of intuition.  Intuition accumulates with experience and with repeated practice of what might have been conscious thinking but was since internalized.  The science paints a grim picture because it implies that sometimes “expertise” is code for “being so good at something you don’t have to think to do it,” which in turn is a fancy phrase for “boredom.”

The point is this – Maybe using the excitement in ever-lasting challenge as the absolute criterion for finding the right career is too optimistic.  As we become better at our work, maybe work becomes just work.  A career is so much more than just the job description – it is also the associated co-workers, bosses, culture, environment, location, and customers to name a few.  Perhaps the secret to a happy professional life is to widen the angle of our lens to include all the relevant parts.

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Howard Chen
Vice Chair for Artificial Intelligence at Cleveland Clinic Diagnostics Institute
Howard is passionate about making diagnostic tests more accurate, expedient, and affordable through disciplined implementation of advanced technology. He previously served as Chief Informatics Officer for Imaging, where he led teams deploying and unifying radiology applications and AI in a multi-state, multi-hospital environment. Blog opinions are his own and in no way reflect those of the employer.

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