“When men are most sure and arrogant, they are commonly the most mistaken”

       – David Hume, Scottish Philosopher and Empiricist

 

In our life and work, two prevailing attitudes can cause great suffering, impede progress, or destroy genuine joy. It is hubris and cynicism.

Hubris is the excessive pride or arrogance we display from ignoring the fact that our minds are biased towards our narrative. Often we are reluctant to honestly examine our selves or the work we have done. Therefore, we end up looking naive or creating false hopes. With hubris, we often can become blinded by these unexamined narratives. At its worse, the false narratives that we have latched onto can cause great suffering.

Hubris, undoubtedly, can be a problem in healthcare. Surgeon and writer Atul Gawande argues that the collective reluctance of society and medical institutions to recognize the limits of what we can do as professionals–particularly when it comes to aging and death–end up increasing the suffering of patients towards the end of life. In a piece written for the New York Times, he tells the story of how his daughter’s piano teacher who faced terminal cancer and the crucial choices she made about how to spend her final days. His daughter’s teacher was only able to do this because of an open honesty from her physician and the people around her.

As an oncologist, I believe I must ask my patients penetrating questions and help guide them to the kind of treatment that is most appropriate based on their goals and priorities- or whether treatment is appropriate at all.

On the other end of the spectrum, cynicism can also be a problem in healthcare. As doctors, we are often forced to negotiate between imperatives of policy, pressures of organizational performance metrics, and the demands of good practice. Cynicism arises in the turmoil of complicated feelings elicited by such contexts. In one study, about one in five physicians and nurses in a large academic institution scored highly on cynicism.

Unchecked, cynicism is typically regarded as a cause of distrust and a pathway to burnout. This ends up being bad for patients, for healthcare organizations, and the physicians themselves.

But we do need the hope and confidence seen in hubris to lift our spirits–not becoming paralyzed with helplessness. At the same time, we also need the critical examination from the cynic to see the world accurately–making better decisions and not lead to false hopes.

This is why skepticism is essential for a life well lived. After all, it is skepticism that launches scientific discovery and progress forward. Perhaps skepticism gets a bad wrap, often confused with being cynical. But there is a significant distinction. While a cynical person believes the worse in something or someone–no matter the evidence. A skeptical person refuses to accept something without evidence or solid reasoning. The skeptic has doubt but looks into something with a curious inquiry. She is willing to change her mind examining the evidence and asking the important, tough questions that others do not.

It is the examination and inquiry into these tough questions how we get closer to the “truth.” And it is skepticism that can spur our creativity to come up with better solutions and ideas that will lead to genuine improvements. It is the seed of doubt and not taking something at face value that is the first step to indeed creating a meaningful and better life. That is why skepticism is the golden mean between hubris and cynicism. It is not only crucial for me as an oncologist to remain skeptical, but also vital for us all so we can live a more meaningful and fulfilling life.

I am a gynecologic oncologist, a husband, and a father. My blog is mostly about our healthcare system and well-being, but occasionally I get inspired to write about other "stuff" too.

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