1) Always put the patient first. Duh, right? This is, after all, your passion. Unless you entered medicine for the wrong reasons, you think helping people is, well…cool, and you signed up because you wanted to make it your career. That said, you soon realize after signing up that there are an unbelievably large number of things that will draw your attention away from the patient, whether it’s politics (read: fear of being fired), financial concerns, ethical dilemmas, whatever. But no matter what, you can’t ever forget: you’re treating a fellow human being. Even if someone’s 100 years old, that someone is someone’s kid. So while this rule may seem inherently obvious, just keep it in the back of your mind–use it as your compass to point you back to humanity whenever you might walk astray.

2) Look cool while doing it. Ok, so at first this rule definitely sounds a tad arrogant, but it makes sense. You wear the white coat of a professional. People hold you to ridiculously high standards whether you like it or not, and you owe it to everyone else who wears the white coat not to mess that up. And don’t just be happy with “not messing it up”–push the standard further. If you’re a surgeon, be awesome at the technical skills you’ve honed. If you’re a pediatrician, help those kids grow up strong, tall, and smart. If you’re into psychiatry, be the most understanding person your patient has ever met. And so on and so forth. Strive to be great unmatchable in your mastery of the field, and you’ll soon be described by those around you as “baller”, “legit”, “hawt”, and other such fashionable words of adoration.

3) Don’t hurt anything with a name. Surgeons have a slightly narrower pancreas-related version of this in their 3 rules, but basically, this broadly applies to your patient, your patient’s innards (we all had to pass anatomy, right?), the rest of the staff, your institution, the “doctor” title, your family, you…the list is pretty much infinite. Are sacrifices sometimes required? I suppose so. But as cliche as it might sound, it really is our ethical and professional duty to minimize sacrifices whenever possible.

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At the end of the day, we all have times when we’re tired. When life just kinda sucks. That’s natural. It’s ok. Take a deep breath, do what you need to give yourself a boost of confidence, and keep on chuggin’ away. I hope everyone who reads this finds it useful–goodness knows I’ll constantly be referring back to this whenever I’m feeling lost and need a sanity check.

But wait, cry all the self-help coaches, overachievers, and med students. Perfectionism is good! It drives us to achieve, to surpass our limitations, to be all we can be! Without perfectionism, without an obsessive desire to attain the unattainable, we would have no progress, no innovation, no nothing!

Utter nonsense, my dear Type A’s. What you have fallen victim to is simply a misuse of semantics that perfectionists universally delude themselves with to justify their habits/natures. I would know–I was one, and to a certain extent, still am.

As a perfectionist in recovery, I want to first make clear the extremely important distinction between “striving for excellence” and “perfectionism”. Society and vernacular often treat them as one and the same, BUT the latter is the former taken to extremes.

Excellence is a worthy goal–the best goal, really–for not only physicians, but for anyone in any profession. One of my favorite quotes by Dr. Martin Luther King Jr. is, “If you are called to be a street sweeper, sweep streets even as Michelangelo painted, or Beethoven composed music, or Shakespeare wrote poetry. Sweep streets so well that all the hosts of heaven and earth will pause to say, ‘Here lived a great street sweeper who did his job well.’” And I think this quote does an excellent job of highlighting the key aspect of excellence that distinguishes it from perfection–excellence is possible. Striving for excellence, then, means working toward the realistic goal of attaining maximum performance from one’s capabilities.

This of course raises the question of “How do I know what my capabilities are if I don’t push myself as much as I can?” I have to concede that without motivation/drive, we would all be useless fools–but when we use this question as an excuse to excessively sacrifice other parts of our lives, that is where I draw the line between practicality and delusion.

Unhealthy sacrifice is the major hallmark of perfectionism. At some point in the pursuit of perfectionism in a field/profession/pursuit, we begin to let go of other key priorities and lose the tenet that success is a very holistic term. What do I mean by holistic? I define success as the following (in order of importance):

1. being physically fit–if you’re not alive and healthy, the rest is impossible. Duh.
2. having strong relationships with others–I think just about every overachieving academic has had at least one awkward moment in their life when they realize that after spending all that time cooped up studying, they don’t know anyone who can write them a strong letter of recommendation. I’m not saying go out and spend all your time networking, but really, if someone has this issue, it’s quite likely they don’t have very many close friends either. Let’s be real, I have classmates who are generally despised, and while everyone generally do a good job of hiding this loathing with Oscar-worthy facades, I have to wonder what they’ll eventually go through. Somewhere along the line, whether it’s through a patient (lawsuit), friend (defriended on Facebook), spouse (divorce), or whoever–their style is going to bite them in the ass.
3. hobbies–you need to know what you’re interested in, and develop them. Hobbies are, by definition, activities that give you pleasure. Everyone who has ever become famous achieved fame because they spent their life doing what they loved, whether it’s math, science, music, politics, whatever. So spend time on your hobbies–it could get you famous.
4. academic achievement–I hesitate to list this, but it IS important as a medical student. After all, without a reasonably solid knowledge base, how can one be a good doctor? I do, however, list it last. Yeah. Last. Why? Because if you really believe academic accomplishments define you to the point where it takes precedence over your health, relationships, and happiness, you are, in fact, an idiot who will probably die alone with no one to attend your funeral.

All four of these factors are key to success–succeeding in only one or a few is, in fact, being the so-called “failure at life”. Why? Because life isn’t just about being able to run a mile in <10 minutes, or having good friends, or being able to play piano/sing like a diva/drink like a champ, or rocking exams. It’s about finding the right mix of all of these abilities, and striking a holistic balance. What that balance is will be slightly different for everyone, but ignoring or downplaying one part will ultimately degrade your performance in the others. Think about it. People who only do athletics earn the reputation of being dumb jocks. People who party all the time probably aren’t doing so hot in class. People who only do their hobbies are the eccentrics that no one really wants to admit knowing. And people who do nothing but study are the gunners that probably end up gaining weight, burning out, and, statistically speaking, having the highest probability of committing suicide in the healthcare profession.

So again, I stress that balance is key. And it is un. fucking. believable how many excuses people come up with to save themselves the trouble. When’s the last time you heard a variant of “I don’t have enough time” or “I have to study” from someone? Chances are it wasn’t too long ago. And of course, sure, if it’s the week before finals, by all means, study till your brain feels fried–do what you have to do to pass. But realize that’s only a few weeks out of the whole year.

Tips for beating perfectionism:

• Make sure you have a “fuck it” point, and friends who know what it ought to be. You need to realize when you’re taking something too far, and just in case you do get caught up and don’t realize it, you need buds who will come to your rescue and save you from yourself.
• Perfectionism is the inherent belief in a limit–an unattainable one. So instead, believe that you have no limits, and work to back that up. Work hard, put in the best effort you possibly can, and learn to be happy with what you are able to accomplish each day.
• Perfectionism is usually paired with the incredibly annoying habit of being arrogant. As human beings we all want to feel validated, and when we pour time and energy into something we expect others to take notice and applaud our efforts. A bit of bragging never hurt anyone, but when this becomes a habit you just look dumb. Be humble about your accomplishments, and let them speak for you–actually, if things go well, you might find nothing is said at all in the process! (think about it–Nobel Prize winners are only notified by a brief phone call once they’ve been selected)