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Thumbs Up or Thumbs Down?
My last post was about how vulnerability, often thought of as a flaw to be squashed, can be really important for medical decision making and patient safety. This was still fresh in my mind when I spoke at the New York State Society of Anesthesiologists big annual meeting in Times Square, and it found its way into my presentation in a totally unexpected and unscripted way.

I’d been asked by the Foundation for Anesthesia Education and Research (FAER) to speak on their plenary panel, specifically to spend 40 minutes talking about my own experience and successes as an education researcher and a former FAER grant recipient. This was an interesting invitation, and required a lot of introspection. For one thing, it felt a little bit like having a party for myself from the podium, and I wanted instead to deliver some tangible advice for the audience. For another, I have had my share of big-time failures as well as successes. As I put together my presentation, the vulnerability concept emerged again and again. What does vulnerability have to do with success as a researcher, or any other field of work?

Putting anything creative or personal into the public domain requires a huge amount of vulnerability. Whenever I accept an invitation to speak, I’m open to both praise and criticism. Usually, I get a lot of positive feedback when I speak or facilitate a workshop. Occasionally, I get some constructive criticism with actionable ideas for improvement in either content or delivery. Very rarely, I come across a mean-spirited remark that is not helpful at all. Although everyone loves a compliment, most of us don’t like negative feedback even when it is constructive, because it doesn’t feel as good as praise. And of course, personal criticism or insults can hurt. However, it is simply impossible to speak in public without being open to critique. Some presentations may be amazing, and some might fall flat. However, you can experience a failure without being a failure.

Researching and writing are the same. When I was just starting out in my career, many people didn’t think my area of interest was sufficiently compelling to warrant grant funding, or even to warrant a publication (I eventually got both, and much more). Despite that, I felt passionate about the psychology of medical decision making, so I pursued it. In many ways, that left me very vulnerable. Would anyone care about the work? Would it be unpublishable? Would I fail big-time, and in a high-visibility way? I did it anyway. Not everyone will like your work, and that’s OK. I am not fascinated by every book or journal article I read either. Some readers might not see any value in this blog post, for example. That’s just fine. With the courage that comes from embracing vulnerability, you resiliently stay focused on delivering your best for those whom your work serves well. Without embracing vulnerability, the only choice is to quit.

Practicing medicine is also the same. Medical decisions are judged, often by people who were not present at the time the events were evolving and decisions were made. These folks typically also have the benefit of knowing the outcome, which unduly influences peoples’ opinions on decision quality. Usually, people only bother to critique decisions that accompany adverse outcomes. Therefore, if you are going to practice the uncertain art and science of medicine, you’re likely to face scrutiny at some point. If you take on complex cases and rare disorders, you’re more likely to have adverse outcomes. With the courage that comes from embracing vulnerability, you can give your best care to the patients who seek it, even in the face of uncertainty, high risk, and high stakes. Without vulnerability, you cannot help anyone.

Although it may sound paradoxical, a critical component of success in any career – as a researcher, an educator, a speaker, a writer, a doctor, a chef, a fashion designer, a entrepreneur, or really just about anything – is vulnerability. If you can’t be vulnerable, you can’t be anything. And that’s a waste of the unique talents you have, and a loss to those whom you can serve with your work.


Have you ever held yourself back from an opportunity, pursuit, or passion because you were afraid of being criticized?


Note: As I mentioned in my first post about vulnerability, these ideas were inspired by hearing Dr. Brene Brown speak with Oprah Winfrey on a radio show. Since then, I’ve purchased the audio version of Dr. Brown’s book, which I highly recommend.


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