coming of age?

My brother emailed me yesterday. He was at a proverbial crossroad in his education/career/life. He was worried about the choices in front of him. He was looking for answers, he was looking for guidance, he was looking for more sleep at night. Reading his email, I could not help but wonder whether there is a gene which codes for 'thought process'. it seemed as if I was visiting my brain from the past - the questions that floated up from his email would have been typed by me not so long ago. You see, he is thinking about applying for a PhD and he is not sure. His words jumped off my screen like unruly kids off a schoolbus:
What can I look forward to if I do complete my PhD?
How long will it take?
What if I can't come up with anything for years and realise I have to quit? What do I do afterwards? A research job?
But do I so badly want to TEACH?
Am I any good at it?
Am I good enough for any of this?
and also ...

... What do I want?


I could also identify with his state of mind when he said: 'It's been 5 months and I haven't even done a proper literature survey. I feel I'm not as self motivated or as interested as I need to be for research'. It is uncanny how our thoughts have lined up with no intentional mutual influence, living thousands of miles away.

What do I tell him? The obvious, annoying and easy answer is to say 'there is no right answer'. But you don't need a brother to tell you that. You can get it from the innumerable agony aunts all around you in the media.
But, then, is there a right answer? Maybe there is, I don't know, but what I do know is .. I don't know if there is a right answer.

I began thinking about the one thing I could tell him which might be of use to him - how I coped with these questions that life flings at you with apparent carelessness, but really with an intent to maim or kill.

That got me thinking about my life over the past three years - nothing to write home about, but still, I came to acknowledge a few basic 'facts' as I see them.

After I finished my MRCP, I felt stranded, as if I had lost direction. I ‘knew’ I was not good enough for anything acute, anything exciting. I ‘knew’ I did not have enough knowledge about medicine to ever become a specialist, I ‘knew’ I did not have the commitment and dedication to pursue a career in a competitive academic field. My head was all muddled and I had no obvious path to follow. Till then when I had exams to pass, it was so easy (not being arrogant - I don't mean that the exams were easy, God, did they make me sweat and loosen my sphincters at times). Look at the next exam date, apply and study. Hardly requires any decision making skills. But when I had finished all my exams, it was as if it was the end of my career. What next?

I then thought about my future working life.

It became slightly less muddled over the next few months - it was as if I had finally got down to 'spring cleaning' my mind, airing the cupboards, sweeping up the cobwebs and dusting the carpets. My thoughts started to bear semblance to some kind of order. Somehow, it was as if, I was alive for the first time, just starting out, testing if my brain works or not - very strange after 'living' for 26 years.

I started with what I would call 'first principles' in my work.

A job is defined as work you do for financial compensation

A profession is a job that you do offering a degree of expertise that someone just doing a 'job' cannot offer. This means you have undergone a period of specialist training or education that gives you a better insight into what you do. Yet, it is something you do for remuneration albeit at a better skill level.

Now, there is one more level of work – a vocation. Etymologically, this is related to the concept of a ‘calling’. As if the work calls you, attracts you and you fall in love with it. You have a desire to do it, you want to do it because it is what you would enjoy. Moreover, it is what you would enjoy not just at the age of 28 when you are young and fit and the world is your oyster, but it is what you would enjoy at the age of 65 or 70, when you have arthritis in both hips and problems with your prostate that makes you lose half your sleep running back and forth to the toilet. In other words, it is something you would not tire of doing because you love it.

With this line of thinking came the realisation that choosing my career path was as important as choosing who I live with/marry. Well, even more important, in some ways.

The person you marry might not be there with you throughout your life for whatever reasons, but your work will be with you as long as you are capable of working.

IF you do not choose carefully, you might end up hating what you do very soon – and when it happens, it is as ugly as a bad marriage.

I then imagined this: what would it take for me to jump out of bed into my work clothes at 3 AM … at the age of 65?

The answer was very obvious – cardiology, cardiology and cardiology in that order.

According to a survey which I came across a few years ago, only 11% of cardiology trainees in the UK are non-White, of which 7% are Asian of which 4% are British Asian born and educated in the UK. The situation might have changed, but I do not think it has changed dramatically.

In other words, I knew when I decided on cardiology that I have a 3% chance of making it to a training post. 3 years down the line, I am only half way there (if that) – I still don’t know if I will manage to get a training post. Yet, I would NEVER ever consider doing anything else with my life. Because it would not be physiologically plausible for me to do anything else. You might as well train your goldfish to fetch your morning paper.

People ask me what is my plan B – I don’t have a plan B. The only plan is cardiology ... or sit at home and look after the kids, which is quite attractive, I must say, atleast that would save me having to worry about IVF and elderly primis.

Then comes the question of choosing an academic route – research and all the rest.

It is much more difficult to marry research into work – in any field. Again, it depends on how much you love your field. Applying the same useful office equipment, the 'first principles sorter' (available now, in all good shops):

In any line of work, traditionally, you do three things:

Do a good job (profession)

Teach your apprentices how to do a good job (academics)

Try to see if you can make the job better (research)


Whether you want to do 2 & 3 depends on two things:

How much you want to do it

AND

What are the negative impacts on your lifestyle/quality of life (note: quality of life is defined by you) by choosing 2 and 3.

But then there is a darker side to it, the craving for knowledge (which may turn out to be an ill disguised craving for power, for in academics, knowledge is really power), the desire to be known, to be recognised, to be appreciated, to be immortalised by your work.

Is this just vanity, is this just arrogance?

How should I know, possibly it is just me.

I am still trying to work out how to sift out the dark side. Three things seem to help:

1. Insight - by this I mean an unbiased assessment of oneself - a clincial audit with an 'n of one'. Accept the fact that in a lab with a PCR machine, a pipette, a 200 microlitre pcr tube and you, the imperfect entity is... yes, no prizes for guessing... you. I strongly believe that the more insight you have, the more you question your capabilities. So I am very happy and proud of my brother for raising these doubts about his own capacity and calibre.

2. The project is more important than the researcher - this puts things in perspective. You then come to 'know' your slot in the bigger machine. It gives you the drive to know more, to be excited about what you want to do, it gives you the academic equivalent of a nostril flare response. At the same time, you realise that even if the human race evolved to live to 250 and did away with the need for sleep and developed superneurons with novel aminoacids which give you supermemory, you will only succeed in scratching the surface of your field, the field you really and truly love.

3. Remember your climb up the ladder - as you progress, watch where you step. Try not to tread on feet, especially those of your juniors. It does not take much to squash baby feet with army boots. Try and remember that any comparisons between you and your juniors should be like for like. i.e., be honest and compare your junior's achievements and knowledge to what you were capable of at his/her level in your career. When you appraise someone: be honest, not brutally honest.

Anyway, all this apart, over the next few days/weeks my brother will come to a decision. It might change his entire life. It scares me. Why did he have to ask me for advice? Why not someone older and wiser? Why not someone in his field?

Suddenly I realise, there are questions floating up like good year blimps into my conscious brain...
...and the first one reads:

Am I good enough?