Tag Archives: Life

On The NRMP Residency Match, And What People Meant by “It’ll All Work Out”

The optimal solution of the NRMP match algorithm is deceptively simple, but its implication for the lives of applicants is anything but simple.

Three years ago, my then-girlfriend and I sat down and parsed through what would become the most important determinant of our lives moving forward.

Because we attended different medical schools, we carried on a long distance relationship for five years. The NRMP match was more than just a residency choice. It was also a solution that could finally close our distance and take the relationship forward again.

The ranked list seemed like the most difficult decision we had to make. There were so many variables, each with differing levels of importance.


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Have we begun to think like our media?

Once upon a time, there was no social media.  There was no traditional media.  There wasn’t even writing (yes, we are going way back).

Information relied on stories, particularly stories with well-defined heroes and villains whose actions are followed through elaborate stories of their deeds, as events were far more memorable than simple lists of facts.  Anthropologists believed that information was passed down by song, a natural mnemonic that helped countless village elders remember these elaborate stories. Continue reading

Moving from past perfect to simple future

“What would have been” is easy to imagine.  It’s everything that we don’t have but we want, glazed with the syrup of optimism and a flare of fiction.

“What will be” is also easy to imagine.  It’s everything that hasn’t happened yet but will inevitably become pending our next actionable step, permeated with the grating texture of reality and a hint of truth.

The past perfect tense is exactly what it is – it’s perfect.  But “what would have been” is not quite past perfect.  It’s actually past conditional perfect tense. Conditional because we should have made that perfect decision in the past, but now it exists only in the imagination.

“What will be” is a simple future tense.  It looks ahead with a prediction of the near future.  It’s not quite “what will have been.”  The future perfect is a little far ahead, a little scant on realism.

Simple future isn’t necessarily better or worse than the past perfect conditional or the future perfect.  However, it is different, and we sometimes think too little about it.   So next time you found yourself looking back and thinking down a bifurcation towards a fictional future, it might be worth asking yourself “what’s the next actionable step, and am I willing to take it?”  It brings out the real you.

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. Continue reading

What happened to ‘happily ever after’?

I finished reading novel, I’m not happy with the ending, and that might be a good thing.

With the success of G. R. R. Martin’s A Song of Ice and Fire (better known by the name of its first book, also the television namesake, A Game of Thrones), in today’s young adult fiction genre, gritty – or “realistic” – fantasy is all the rage.  And gritty fantasies do. not. end. happily.

Gritty fantasies are about being unpredictable in a way that real life might be – killing epic heroes in mundane ways. If Homer’s Odyssey were a gritty fantasy, Odysseus, after winning countless impossible battles and won against all odds may step on a rusted nail on his way disembarking his ship and die of a tetanus infection.  Lord of the Rings may end with Frodo getting forever lost, having never travelled outside the Shire.  And Ron in the Harry Potter series, being prone to magical misfires and misfortunes, may have ended up losing a few limbs in a gritty fantasy.

It is almost as if the author is trying to create a world that simply lives on parallel to our own – a world with different physical and magical laws, but somehow operates in the same ruthless and moral-neutral manner as our own.  A world where good guys don’t necessarily win, trying hard doesn’t necessarily lead to success, and being lawful doesn’t protect against a guilty verdict.

What makes a character live successfully in the world of gritty fantasy reflects that in the real world: power, money, exploitation.  No one likes to read the endings of dark, gritty novels, but there is something about the deeply unsatisfying ending that makes us ruminate about the journey itself, the little flakes of joyfulness that are scattered variously in fiction and in real life.

It’s a lesson about appreciating life in spite of the possibility for an unhappy ending.

Different people are all different

Many teenagers find it enormously difficult to fit in with the crowd, particularly when they also feed the need to stand out.  The things that differentiate us from the next person – love of comic books, thick glasses, or the giant 1mm mole on the left pinky – are frightening to the developing adolescent.

Growing up is realizing that many parts of life require us to embrace our “abnormalities” – impressing a first date (“I never thought I’d find another person who also likes ____.”), acquiring a coveted career position (“My ______ makes me the ideal candidate for your company”), telling a dinner party story (“The most ridiculous thing happened the other day…”).

It seems that being different is extraordinarily difficult.  After all, only a small number of people can be at the tails of the bell curve, and it is easy to feel just so… average.

In medical blood labs, “normal” is a vague definition.  The normal value range actually encompasses only 95% of numbers you would find in healthy people because there is some overlap with lab values in sick patients.  This means that if we measure enough numbers (say, about 20), we would find some abnormal values in everyone, healthy or otherwise.

These laboratory values catch doctors’ eyes.  They warrant extra seconds of discussion on rounds, extra discussion at the bedside for symptoms, and/or repeat laboratory evaluations.  Most of the time further investigations affirms the simple fact that even the most normal person has some measurable outstanding lab values.

In medicine, we learn that the completely average person simply does not exist.

The difference between lab values and real life qualities is that running a panel of 45 blood labs is simple, but identifying our own eccentricities and innate talents takes introspection and feedback from honest friends.  Then, embrace it – life may not have dealt everyone an even hand, but it is fair in that everyone is playing from some kind of a crooked deck.

No more boxes

Albert Einstein once said that “insantiy is doing the same thing over and over again and expecting different results.”  Innovation is, then, about thinking outside the box and finding that brand new idea, right?

Thinking outside the box has become a cliched way to describe innovation – an ironically inside-the-box way to motivate someone.  It is also incredibly difficult, probably because no one really know where the box is, how big it is, or what’s in the box.

Our world is populated with myriad of boxes.  In the new world where information flows at the speed of electrons in every industry, every iteration of an idea has at some point been conceived, if not already attempted.  Google was not the first search engine, Microsoft did not make the first GUI-based operating system, Facebook was not the first social website.  The world had thought the search engine, the GUI, and the social network were niche products for the technology business, the geeks, and the science fiction novels.

Only when looking back 10 years later can we gleam a hint of new boxes in the making during those times.

So maybe “thinking outside the box” had it backwards all along, that we should be thinking without worrying about the box – that when a set-back pushes us down, it is worth to just stand up, brush off the dust on our buttocks, and charge right back into the fray with renewed vigor.  Boxes are for those looking back, not for the people that must keep moving forward.

Cutting through the bell curve

When coming up with new innovation, designs, or just another idea, sooner or later there will come an idea that few people like.

The normal distribution curve is shaped with most of its value surrounding the mean. This is the curve many things in nature follow – most of us are somewhere around the average intelligence, for example. Most people are somewhere around the average height with few tall and short individuals. And most of us have somewhere around the average ability to imagine what the future looks like.

If we were to plot ideas along a bell curve, we would have the few rare brilliant concepts in the far right, where most people in the middle of the bell curve would fail to appreciate.

So sometimes truly great ideas are so out of the box it is a statistical certainty that they are lost to the appreciation of the masses.

The question is, what will you do when you find next idea surrounded by nay-sayers – will you listen to them, or will you push forward with head held high?


The self-narrating animal

“We’re sto­ry­telling crea­tures by na­ture, and we tell our­selves story after story until we come up with an ex­pla­na­tion that we like and that sounds rea­son­able enough to be­lieve. And when the story por­trays us in a more glow­ing and pos­i­tive light, so much the bet­ter.”

– Dan Ariely, The (Honest) Truth About Dishonesty

We debate in groups but think in solitude

Conversations are meant to be transformational – it is the reason why language exists. Famous leaders sometimes prefer high-octane debates over consensus building.  Jeff Bezos and Amazon is famous for using confrontational, high-decibel verbal exchanges for decision-making.

But people and companies are different – in much the same way that your best friend may be a great listener over drinks in private but turns into the most confrontational, obnoxious jerk when the group gets big enough.

Humans are social animals.  But we are also solitary animals.  We are different animals in different settings. Continue reading