The Ordinary and the Extraordinary
It is not given to everybody to do extraordinary things. It is more important to do ordinary things in an extraordinary way
Dr P K Sethi
There have been two people who have impressed me in my life, who have shaped my personality and character in a substantial way. One was my teacher,’ my friend philosopher and guide ‘as the cliché goes, Dr P K Sethi. The other was Dr B Mukhopadhya.
Dr Mukhopadhya, an orthopedic surgeon and one time Dean of Patna Medical College, was an extraordinary man of extraordinary accomplishments. He was the first Indian Hunterian Lecturer of Royal college of Surgeons, England, and was awarded Padma Bhushan in 1970 and the B C Roy award in 1989.He was a Rockefeller and Smith and Nephew fellow and the founder secretary and President of I O A, as also the founder fellow of the Indian Academy of Medical Sciences . However, it’s not his tremendous achievements which impressed me. I belong to that genre of non-achievers who when confronted with such exalted accomplishments tend to perk up “so what”, simply because they know such laurels are way out of their capabilities.
He was a contemporary of Dr Sethi, and his close friend and confidante. The two shared a venerable camaraderie, and seemed to share a lot in common. What impressed me was their commitment to certain principles, very ordinary but extraordinarily rare.
In 1997, at the behest of Dr Sethi, I organized at Bikaner the COE course of the Orthopaedic research and education foundation created by Dr Mukhopadhya, and there began my tryst with Dr Mukhopadhya. Bikaner is a peaceful, lazy town seldom stirred even by the extraordinary. No one believes in doing anything by the clock. We were to start the inauguration in the evening, so it was no great surprise when at the appointed hour the only people present in the auditorium were Prof Mukhopadhya, the faculty of the course, few delegates and a handful of volunteers and virtually no audience. Dr Mukhopadhya looked around, waited for ten minutes and then spoke up “Rakesh, we have to start”. I was piqued but marveled at his penchant for punctuality. I could only muster “Yes Sir”, and we started.
It did hurt me that his obsession had caused me some embarrassment, but it made me wonder how exact and precise this man must be. During the course, Dr Shailendra Bhattacharya., the renowned senior orthopaedic surgeon of Kolkata, and Dr Mukhopadhya’s close confidant and dear friend was lecturing. As so often happens, he overshot his allotted time. Dr Mukhopadhya waited for two or three minutes, then interjected “Shailendra, that’s enough. Your time is up”
Again, it didn’t impress me that he had stopped his close friend in mid stance. It was his equanimity that impressed me. It’s not that you have no consideration for your near and dear, for the exalted and the influential. It’s that your behavior is the same no matter whom. In the words of Prof Higgins of George Bernard Shaw’s ‘Pygmalion’, “It’s not as if I treat you like a common flower girl when I should be treating you like a duchess, but whether I treat a duchess any better. It’s not important to have one set of feelings for someone and another set for someone else, but having the same sort of feelings for everyone.”
Equanimity is an integral part of being exact, an ordinary virtue yet extraordinary to find. How often we are left waiting and stranded at scientific meets and conferences because someone who matters is late! Why do sessions get delayed and prolonged because someone is stealing time and grabbing more than his due? What is needed is someone who can level the playing field, stopping for no one, macadamizing the trespassers of time and schedules.
I don’t know how many of you are aware of what is now known in the corporate circles as the TOYOTA WAY.
Toyota has 14 principles for optimizing and maximizing work output. The first and foremost among them is avoiding waste__ of time, money, effort and manpower. This is achieved by planning, identifying the problem areas, delegating tasks, setting time frames and schedules , ensuring compliance, reviewing progress through face to face meeting and ensuring timely completion. I don’t know if Dr Mukhopadhya was aware of this or not, but he certainly followed these principles while shaping his OREF courses.
He spoke only of tested technology, grew leaders who teach to others, developed exceptional people and a team, extended his network of partners, oversaw things himself, made decisions by consensus and strove for continuous improvement.
What relevance does the TOYOTA WAY have for us? Is it really worthwhile to think or talk about these in our professional and daily lives? I would say pretty much yes, if you only pause to analyze your own work life balance.
Anita Houghton is a careers counselor and executive coach. She wrote a series of beautiful articles in the BMJ Career Focus on Personal support, “How to help someone achieve balance in their working and personal lives”
Try this.
Begin by asking yourself
● What are your current roles in your life as a whole?
● What are your responsibilities?
● What are you accountable for in your life and to
whom?
● what do you spend your time doing?
● What do you call yourself as you’re doing these things e.g., parent, spouse, household manager, financial manager, career monger etc...
Define the eight roles in your life you consider the most important
Now draw a wheel, giving each of these roles a sector in the circle, commensurate with the importance you give it
Now honestly assess.
What does your wheel look like?
Chances are it looks like a twin blade propeller, where only two things predominate, you as the surgeon, the professional and you as the money spinner. Or it could be a three winged fan, the third dimension being your all important career.
Or it may be a cross , with the four limbs of the cross consumed by you as the surgeon, you the money spinner, you the careerist. A small and short limb would be you as a friend, a family member and fun seeker going for very occasional outings and vacations. In a few instances it may be a pentagon or a hexagon, the fifth role being that of the householder.
Look at the one role or sector which is sadly missing in all these shapes, preventing it from becoming a complete whole, namely, a circle. It is the partner and the lover.
In fact, this question is more pertinent to the spouse. Are you satisfied with the amount of time your better half spends with you and your children?
It may be news to you that doctors are not considered the best of better halves.
When I was an intern, a debate was held in institution ”Should doctors marry only doctors.My contention was yes, not because they are more compatible but because that is the only way of decimating a non clubbable class of individuals, and it would be far better to ruin a single household than to ruin two. At the end of my discourse I posed a query. Given a second chance how many of the doctor couples would choose to make the same choice? I was greeted by a prolonged silence.
Marriage within the profession is a subject of much introspection, precisely because we do not make the best of husbands, or wives.
An article appeared in the BMJ Career Focus in 2006 by Karen Hebert.
It deals with the ease and the hassles of marriage within the profession.
Are medical marriages really any different or just part of the statistics? According to the article by Karen I have just quoted, there is no real difference in divorce rates in medical marriages but there is also evidence that while the marriages are stable, many spouses are chronically unhappy. Michael Myers, a psychiatrist from Vancouver has described a number of particular difficulties that can be faced in a medical marriage.
What are these hassles?
Bhupinder Sandhu, past president of the Women’s Medical Federation, points out: “Partnership in marriage is essential. If you are married to a medic that partnership can come under all sorts of stresses as a result of competing careers, clashing rotas, and the availability of jobs. All too often, it has been the wife who has made the sacrifice, and consequently not benefited or achieved the career that she should have achieved”. Doesn’t it leave that little bit of crick in the heart? How many times you hear of doctor husband and wives living apart due to different posting? Remember distances breed chasms. Companionship is an ordinary virtue but is becoming extraordinarily rare.
Quite some years ago there was a big issue in the British Medical Association on the relevance of the GP in the growing specialization. Does he have a role beyond the referral point for the specialist? I think this focus was the result of an insatiable passion to do the extraordinary, the super specialization, be it endoscopy in surgery, limb salvage in oncology, joint replacement surgery, and what have you. No one wanted to be a general surgeon or physician or orthopaedician. Is it really that imperative to be extraordinary? My chief Dr P K Sethi didn’t feel so, and I feel likewise. Does that mean that Dr Sethi was against modern technology, was too conservative? He felt technology needs to be demystified and put in a more contemporary, cultural and Indian perspective.
Needless to say there is an absolute need to have centres of excellence devoted to specialized work, people who are the super specialists, if you may. Every patient has a right to specialized treatment by a trained specialist, but then do we permit, say, a joint replacement surgery by an inexperienced surgeon? The irony is how does he become experienced if he does not operate. The answer lies in centres of excellence, identified and recognized by our professional bodies running training courses with well defined targets and goals over a predetermined time frame, courses which incorporate a system of evaluation and certification. Only then should one be eligible to perform joint replacement surgery and be labeled as joint replacement surgeon or spine surgeon or hand surgeon or arthroscopist or whatever. Only then will ordinary people be able to do extraordinary things, in a safe and proper way. Safety does not encompass compromisations. You cannot make a half hearted attempt and achieve a safe and satisfactory result. The centres of excellence will impart the proper technique, the safe technique, the uncompromised technique. Unless you have the proper set up, don’t do it.
Does doing the ordinary in an extraordinary way get you anywhere? I think it does, and so did Dr Sethi. There is a virtue in mediocrity, in doing the run-of-the-mill. It is your application which makes the difference. Apples had been falling before. It took a Newton to apply himself to this basic and ordinary issue. It is this that made him extraordinary. Reminds me of a verse by Z.S. Bains ‘On the chessboard of destiny, mediocrity is sure sometime, somewhere, some hidden hand will move a dice or two, to give it the necessary boost so that it reaches the top while the bright ones are held below to wither away and to rot.’ I don’t think satisfaction breeds complacency, it certainly lowers the stress factor.Dont be apprehensive about being ordinary, doing the ordinary. Just do it in an extraordinary way, and that will make you extraordinary.
Austerity is another virtue which seems extraordinary, whereas it should be ordinarily perceptible. Science does not encompass fanfare and show, medicine even less so. What I am talking about is personal austerity. I once read somewhere "If you have to tell people how important you are, you are not important enough”. Why should there be need to advertise yourself as, say, the first to do this or that, in the state or the country? Does it really make a difference? This initiates a different kind of race, and often results in compromisations on indications. The extraordinary turns to ordinary and then banal.
When I was a student, Gopal Das ‘Neeraj’ came for a Kavi sammelan inmy institution. He had just bid goodbye to Bollywood, and he recited a couplet which still echoes within me
Chalo ghut ghaat per yaar jaraa, kya rakha hai alamgiri mein
Jo aye majaa fakiri mein, wo masti kahan amiri mein
Dr P K Sethi
There have been two people who have impressed me in my life, who have shaped my personality and character in a substantial way. One was my teacher,’ my friend philosopher and guide ‘as the cliché goes, Dr P K Sethi. The other was Dr B Mukhopadhya.
Dr Mukhopadhya, an orthopedic surgeon and one time Dean of Patna Medical College, was an extraordinary man of extraordinary accomplishments. He was the first Indian Hunterian Lecturer of Royal college of Surgeons, England, and was awarded Padma Bhushan in 1970 and the B C Roy award in 1989.He was a Rockefeller and Smith and Nephew fellow and the founder secretary and President of I O A, as also the founder fellow of the Indian Academy of Medical Sciences . However, it’s not his tremendous achievements which impressed me. I belong to that genre of non-achievers who when confronted with such exalted accomplishments tend to perk up “so what”, simply because they know such laurels are way out of their capabilities.
He was a contemporary of Dr Sethi, and his close friend and confidante. The two shared a venerable camaraderie, and seemed to share a lot in common. What impressed me was their commitment to certain principles, very ordinary but extraordinarily rare.
In 1997, at the behest of Dr Sethi, I organized at Bikaner the COE course of the Orthopaedic research and education foundation created by Dr Mukhopadhya, and there began my tryst with Dr Mukhopadhya. Bikaner is a peaceful, lazy town seldom stirred even by the extraordinary. No one believes in doing anything by the clock. We were to start the inauguration in the evening, so it was no great surprise when at the appointed hour the only people present in the auditorium were Prof Mukhopadhya, the faculty of the course, few delegates and a handful of volunteers and virtually no audience. Dr Mukhopadhya looked around, waited for ten minutes and then spoke up “Rakesh, we have to start”. I was piqued but marveled at his penchant for punctuality. I could only muster “Yes Sir”, and we started.
It did hurt me that his obsession had caused me some embarrassment, but it made me wonder how exact and precise this man must be. During the course, Dr Shailendra Bhattacharya., the renowned senior orthopaedic surgeon of Kolkata, and Dr Mukhopadhya’s close confidant and dear friend was lecturing. As so often happens, he overshot his allotted time. Dr Mukhopadhya waited for two or three minutes, then interjected “Shailendra, that’s enough. Your time is up”
Again, it didn’t impress me that he had stopped his close friend in mid stance. It was his equanimity that impressed me. It’s not that you have no consideration for your near and dear, for the exalted and the influential. It’s that your behavior is the same no matter whom. In the words of Prof Higgins of George Bernard Shaw’s ‘Pygmalion’, “It’s not as if I treat you like a common flower girl when I should be treating you like a duchess, but whether I treat a duchess any better. It’s not important to have one set of feelings for someone and another set for someone else, but having the same sort of feelings for everyone.”
Equanimity is an integral part of being exact, an ordinary virtue yet extraordinary to find. How often we are left waiting and stranded at scientific meets and conferences because someone who matters is late! Why do sessions get delayed and prolonged because someone is stealing time and grabbing more than his due? What is needed is someone who can level the playing field, stopping for no one, macadamizing the trespassers of time and schedules.
I don’t know how many of you are aware of what is now known in the corporate circles as the TOYOTA WAY.
Toyota has 14 principles for optimizing and maximizing work output. The first and foremost among them is avoiding waste__ of time, money, effort and manpower. This is achieved by planning, identifying the problem areas, delegating tasks, setting time frames and schedules , ensuring compliance, reviewing progress through face to face meeting and ensuring timely completion. I don’t know if Dr Mukhopadhya was aware of this or not, but he certainly followed these principles while shaping his OREF courses.
He spoke only of tested technology, grew leaders who teach to others, developed exceptional people and a team, extended his network of partners, oversaw things himself, made decisions by consensus and strove for continuous improvement.
What relevance does the TOYOTA WAY have for us? Is it really worthwhile to think or talk about these in our professional and daily lives? I would say pretty much yes, if you only pause to analyze your own work life balance.
Anita Houghton is a careers counselor and executive coach. She wrote a series of beautiful articles in the BMJ Career Focus on Personal support, “How to help someone achieve balance in their working and personal lives”
Try this.
Begin by asking yourself
● What are your current roles in your life as a whole?
● What are your responsibilities?
● What are you accountable for in your life and to
whom?
● what do you spend your time doing?
● What do you call yourself as you’re doing these things e.g., parent, spouse, household manager, financial manager, career monger etc...
Define the eight roles in your life you consider the most important
Now draw a wheel, giving each of these roles a sector in the circle, commensurate with the importance you give it
Now honestly assess.
What does your wheel look like?
Chances are it looks like a twin blade propeller, where only two things predominate, you as the surgeon, the professional and you as the money spinner. Or it could be a three winged fan, the third dimension being your all important career.
Or it may be a cross , with the four limbs of the cross consumed by you as the surgeon, you the money spinner, you the careerist. A small and short limb would be you as a friend, a family member and fun seeker going for very occasional outings and vacations. In a few instances it may be a pentagon or a hexagon, the fifth role being that of the householder.
Look at the one role or sector which is sadly missing in all these shapes, preventing it from becoming a complete whole, namely, a circle. It is the partner and the lover.
In fact, this question is more pertinent to the spouse. Are you satisfied with the amount of time your better half spends with you and your children?
It may be news to you that doctors are not considered the best of better halves.
When I was an intern, a debate was held in institution ”Should doctors marry only doctors.My contention was yes, not because they are more compatible but because that is the only way of decimating a non clubbable class of individuals, and it would be far better to ruin a single household than to ruin two. At the end of my discourse I posed a query. Given a second chance how many of the doctor couples would choose to make the same choice? I was greeted by a prolonged silence.
Marriage within the profession is a subject of much introspection, precisely because we do not make the best of husbands, or wives.
An article appeared in the BMJ Career Focus in 2006 by Karen Hebert.
It deals with the ease and the hassles of marriage within the profession.
Are medical marriages really any different or just part of the statistics? According to the article by Karen I have just quoted, there is no real difference in divorce rates in medical marriages but there is also evidence that while the marriages are stable, many spouses are chronically unhappy. Michael Myers, a psychiatrist from Vancouver has described a number of particular difficulties that can be faced in a medical marriage.
What are these hassles?
Bhupinder Sandhu, past president of the Women’s Medical Federation, points out: “Partnership in marriage is essential. If you are married to a medic that partnership can come under all sorts of stresses as a result of competing careers, clashing rotas, and the availability of jobs. All too often, it has been the wife who has made the sacrifice, and consequently not benefited or achieved the career that she should have achieved”. Doesn’t it leave that little bit of crick in the heart? How many times you hear of doctor husband and wives living apart due to different posting? Remember distances breed chasms. Companionship is an ordinary virtue but is becoming extraordinarily rare.
Quite some years ago there was a big issue in the British Medical Association on the relevance of the GP in the growing specialization. Does he have a role beyond the referral point for the specialist? I think this focus was the result of an insatiable passion to do the extraordinary, the super specialization, be it endoscopy in surgery, limb salvage in oncology, joint replacement surgery, and what have you. No one wanted to be a general surgeon or physician or orthopaedician. Is it really that imperative to be extraordinary? My chief Dr P K Sethi didn’t feel so, and I feel likewise. Does that mean that Dr Sethi was against modern technology, was too conservative? He felt technology needs to be demystified and put in a more contemporary, cultural and Indian perspective.
Needless to say there is an absolute need to have centres of excellence devoted to specialized work, people who are the super specialists, if you may. Every patient has a right to specialized treatment by a trained specialist, but then do we permit, say, a joint replacement surgery by an inexperienced surgeon? The irony is how does he become experienced if he does not operate. The answer lies in centres of excellence, identified and recognized by our professional bodies running training courses with well defined targets and goals over a predetermined time frame, courses which incorporate a system of evaluation and certification. Only then should one be eligible to perform joint replacement surgery and be labeled as joint replacement surgeon or spine surgeon or hand surgeon or arthroscopist or whatever. Only then will ordinary people be able to do extraordinary things, in a safe and proper way. Safety does not encompass compromisations. You cannot make a half hearted attempt and achieve a safe and satisfactory result. The centres of excellence will impart the proper technique, the safe technique, the uncompromised technique. Unless you have the proper set up, don’t do it.
Does doing the ordinary in an extraordinary way get you anywhere? I think it does, and so did Dr Sethi. There is a virtue in mediocrity, in doing the run-of-the-mill. It is your application which makes the difference. Apples had been falling before. It took a Newton to apply himself to this basic and ordinary issue. It is this that made him extraordinary. Reminds me of a verse by Z.S. Bains ‘On the chessboard of destiny, mediocrity is sure sometime, somewhere, some hidden hand will move a dice or two, to give it the necessary boost so that it reaches the top while the bright ones are held below to wither away and to rot.’ I don’t think satisfaction breeds complacency, it certainly lowers the stress factor.Dont be apprehensive about being ordinary, doing the ordinary. Just do it in an extraordinary way, and that will make you extraordinary.
Austerity is another virtue which seems extraordinary, whereas it should be ordinarily perceptible. Science does not encompass fanfare and show, medicine even less so. What I am talking about is personal austerity. I once read somewhere "If you have to tell people how important you are, you are not important enough”. Why should there be need to advertise yourself as, say, the first to do this or that, in the state or the country? Does it really make a difference? This initiates a different kind of race, and often results in compromisations on indications. The extraordinary turns to ordinary and then banal.
When I was a student, Gopal Das ‘Neeraj’ came for a Kavi sammelan inmy institution. He had just bid goodbye to Bollywood, and he recited a couplet which still echoes within me
Chalo ghut ghaat per yaar jaraa, kya rakha hai alamgiri mein
Jo aye majaa fakiri mein, wo masti kahan amiri mein
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