Wednesday, January 2, 2013

To Value Struggle


I’m not sure when it happened, and I doubt anyone living could recall a different time.  Regardless, somewhere along the way we as a society began a journey away from the process to focus on results. I recently read about a study in the field of education looking at this.  A group of 1st grade students from the United States was matched with a group of students from an Eastern country and given an hour to solve an insolvable math problem. The students from the United States worked for an average of 30 seconds before giving up. The students from the Eastern country spent the entire hour working, despite the problem having no answer.  The study was designed to look at struggle, or how children react to challenge. The implications were that we value results more than the process itself. 

Although this study was in the education arena, I immediately saw cross over into healthcare. Medicine as a field is structured to be results driven. Hospitals, physicians, and therapists are graded and reimbursed according to results. Did the patient’s blood pressure normalize? Was the diabetes managed? Just like in education, the reason results trump process is because it is easier to measure success with data. How, for instance, would we gauge a successful process of weight loss without looking at results?

Yet, there have been immense consequences by ignoring the process and focusing only on results. It has led to the desire for immediacy and avoidance of challenge. If we value the end result, then the quickest, easiest way there, becomes the goal. If your blood pressure is high, let’s give you a pill, instead of the agonizing process of changing your lifestyle.

I see this especially with pain. Emotional, physical, spiritual, it doesn't matter the source, we want it gone immediately. Quite simply, as the education study showed, we don’t value struggle.  Had we as children been told “You should be proud of how long you stuck with that problem” rather than being praised for the solution, would things be different?

Instead, as we face hard things in our lives, we don’t think, what is this teaching me? Instead we say, get me out of this immediately. This focus on results has even effected how we face death.  Patients display this when they've been told they are dying and subsequently want it over immediately. The frustration and angst during the sometimes slow process of dying would be different if we valued struggle.  Sometimes it is the families, requesting more medications to mask an uncomfortable process, rather than explore why there is discomfort.

We in healthcare do this too. We have gotten so attuned to results that we are more comfortable ordering more tests and more therapies that give results, rather than looking at what processes are at hand.  If all of us were more comfortable with the process and struggles of aging, perhaps we would better recognize when dying begins.

I don’t think we should lose our emphasis on results, as it is partly this drive that has made us great. A balance, though, would benefit us all. With that said, we should relish in the struggle to get there.


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