Just got back from an overnight paddle-camping trip on the lower Wisconsin River, and I was surprised how casual it was to plan/execute a four man expedition in the wilderness of Madison’s backyard. (This is a good place to thank the wonderful women in our lives for driving; thank you!) We paddled 3 boats 20 miles starting at 5pm on Tuesday and returning me to the office by 9am Wednesday. In the 16 hour interim, we watched the sun set and rise over the water, saw more eagles than people, and roasted marshmallows on a sandbar. A perfect summer condensed into a single night.
So why have so few people I know actually taken advantage of this phenomenal (free) Wisconsin getaway? It could be that they are not interested, but I have talked to many people who have a sincere desire but haven’t made the trip. Is it that they lack the opportunity? Doubtful—it is free, accessible, and manageable with basic camping gear and a glorified inner-tube to float on. My guess, then, is that people who have the desire and the opportunity to do something might just not know where to start. It can be daunting to approach a completely foreign task for the first time.
For that reason, I’ve always balked at the slogan just do it. The reality is that no one ever just graduates to hero status without an accumulation of experiences and knowledge to base it on. Courageous moments and leaps of faith usually happen in the context of a reasonable assumption of risk. This is true in business, exploration, athletics, and especially in medicine. For example, can you picture a Nike commercial featuring the sweating face of Kilian Jornet, record holder for running up and down the Matterhorn in 2 hrs and 52 min? Just do it, Kilian! Except what you wouldn’t see in the commercial is the lifetime of training nor the month Jornet spent living in his van at base camp preparing for the run. Nor would Nike show you the post interview in which Jornet says “I am happy because I didn’t have to take too many risks.”
Business books might be the worst culprits of touting the insane advice to Just do it. Giving people advice to quit their jobs and bravely pursue their passion sells a lot of books, but it does not work. These overzealous entrepreneurs end up as successful as a couch potato who decides to imprudently emulate Jornet’s Matterhorn speed record.
But in no field is Just do it a worse slogan than in medicine. Don’t ever expect to be confident the first time you do something—if you are, that’s arrogance, and it will actually hinder your learning. Confidence and competence result from painstaking years of preparation. Persistent hard work gets doctors to the point where diagnoses are intuitive and surgeries are as familiar as brushing one’s teeth. Whether you want to paddle-camp in the wilderness or treat patients, start small. The moment of Just doing something is the tip of the ice berg that is medical education.