Imposter syndrome dreams and Warren Buffett's counterintuitive advice on reputation impacting motivation

A guest on the Kim Komando show mentioned a classic nightmare theme that particularly torments people afflicted with the imposter syndrome: dreaming of an impending test, often a college final exam, for which one is unprepared, frequently because of never attending lectures for that class or studying for it. I've had such dreams TNTC — medical lingo for too numerous to count.

Another frequent nightmare is discovering that I, sleep-deprived as I chronically am, will soon work the night shift in a busy high-acuity emergency department (as I did for years as an ER doctor) despite beginning the 12-hour shift utterly exhausted. Ditto.

Another nightmare rerun is dreading an impending ER shift because I wasn't prepared to handle cardiopulmonary resuscitations (“coding” someone) using ACLS algorithms and other knowledge required to optimize outcomes. This gets at the heart of the imposter syndrome: it usually plagues the most conscientious and prepared people, not those with big heads and small minds deluded by the Dunning-Kruger effect, in which the least competent are often the most confident, utterly unaware of what they don't know — what I call meta-ignorance.

The irony is that coding patients is what I did best. When I worked as an ER doctor, the average success rate for outpatient codes was 5% whereas mine was significantly better, generally saving the majority of patients (or darn close to that) except when they were a lost cause, such as when it took 45 minutes for an ambulance to reach the patient who collapsed during a race deep in the woods, accessible only by a narrow trail, then another 45 minutes to get out.

My ER nightmares were never assuaged by my track record of successfully coding patients, nor were other imposter syndrome nightmares obviated by me having graduated in the top 1% of my medical school class (despite then having almost zero interest in medicine), my residency director claiming I was the smartest resident they ever had, one of my bosses saying I was the smartest doctor he ever met, and the experienced ER head nurse who worked with me most said I was the best diagnostician he ever knew. For people who innately doubt themselves, no validation of their objective merit is ever enough.

This is both bad and good. The downside is perpetual, needless torment of thinking you don’t measure up. The upside is that harsh self-assessments often incentivize people to remain in high gear, eternally seeking to prove themselves. In the end, that can result in them accomplishing much more.

As I mentioned in one of my ER websites, research suggests that motivation can also be catalyzed by disparagement in the form of social rejection. This is so phenomenally effective that educators should encourage people to distance themselves from the crowd and even to goad them into marginalizing you or anyone who hopes to maximize their potential. That isn't a comfortable place to be, but if you want to do something great, brainpower often isn't enough. The world is teeming with bright and brilliant people yet few do anything to make their mark on history.

I know many very smart people with great jobs and good incomes that erode their potential to do much more than they have. I think the goal should be to not keep doing what you've been doing — one reason I exited ER medicine and never looked back — but to go where no man or woman has gone before.

Perhaps biting off more than I can chew, I've devoted years to writing a book (now 4463 pages and growing daily) that highlights the imperative to make the exposome a new medical specialty.

I am also writing a book presenting a new approach to racism that is being horribly mismanaged in the United States as evidenced by it being increasingly in the spotlight without measurable improvements but often incandescent exacerbations fueling animosity that inflames amygdalae but never gets at the heart of the underlying problems that, if intelligently addressed, would surely narrow and perhaps eliminate the income equity gap used as evidence of racism.

My addiction to reading the medical literature 365 days per year resulted in me finding ways to amplify the success of Black and Hispanic folks (and others to a somewhat lesser degree because certain factors disproportionately impact Blacks and Hispanics). I often wondered why others didn't connect the dots to implement those research findings into actionable advice, so I did.

Addressing one of the big problems in the world today, I developed hundreds of solutions that I am now winnowing into prototypes for real-world testing. Once I file for a patent, I eagerly anticipate showing the world what I've developed.

I am thrilled with the efficacy of my innovation that removes leaves from lawns faster than leaf blowers, lawn vacuums, and lawn sweepers despite my device having no engine or motor — it is so efficient, it doesn't need one. I have two of the best electric leaf blowers and a backpack two-stroke blower that was the best one in the world when it was produced. Simultaneously using all three, my invention removes leaves faster and with virtually no noise, pollution, dust, or vibration. My latest relevant breakthrough was figuring out how to make it using a 3-D printer, thus permitting distributed manufacturing that could be a key to reinvigorating American manufacturing while eliminating the need for people to pack themselves like sardines into cities. Live wherever you want, go to work in your garage or shed — life is good. I should mention that 3-D printers can work while you sleep, read, or play with your children or pets. As someone who once slaved away in 20th century factories, I prefer the new approach to manufacturing.

Over the years, I developed practical solutions to numerous problems. Long before SARS-CoV-2 emerged, I developed a way to circumvent the primary driver of airborne infectious diseases: the fact that we inhale air — and germs — recently exhaled by others. Early in the current pandemic, I developed and tested prototypes, then posted videos to document their effectiveness that is greater than that of masks, social distancing, lockdowns, vaccines, and therapeutics combined.

One of my COVID-19 websites shows a small fraction of what I developed, which took my focus off what I had been working on: exercise devices requiring almost no space (and zero footprint) yet capable of replicating virtually any exercise. I laboriously built those prototypes by hand, each often taking one month or more to produce. Now that I learned CAD and have 3-D printers, I am — time permitting — transforming those designs into 3-D printed products.

Living in northern Michigan as I do and tired of people being injured or killed in car accidents, the death of a 17-year-old on her way to the Northwestern Michigan Fair prompted me to build prototypes of an idea I had to vastly improve automotive (or other vehicle) braking, steering, and traction on virtually any surface, from dry roads to ones covered by rain, snow, ice, or even wet ice. After Kelsey Purchase died on August 12, 2015, I tested my innovations on the most challenging conditions and, amazed by their effectiveness, wondered why automotive engineers haven't introduced comparable technology. My guess is that they are too complacent, too comfortable in jobs and their paychecks that will continue to come even if breakthroughs do not.

Billionaire Warren Buffett asked one of the most incisive questions of all time: “Would you prefer to be the greatest lover in the world and known as the worst, or would you prefer to be the worst lover and known as the greatest?”

In our culture, overly focused on reputation as it is, many people would choose to be known as the greatest even though they were the worst. I prefer the opposite. My goal is to do as much as possible for the world, which I cannot by resting on my laurels. A perpetual case of the imposter syndrome is thus a priceless adjunct to motivation that propels people from fun lives to meaningful ones helping others, often in ways they deem impossible. Stay tuned for that.

The views expressed on this page may or may not reflect my current opinions, nor do they necessarily represent my past ones. After reading a slice of what I wrote in my various websites and books, you may conclude that I am a liberal Democrat or a conservative Republican. Wrong; there is a better alternative. Just as the primary benefit from debate classes results when students present and defend opinions contrary to their own, I use a similar strategy as a creative writing tool to expand my brainpower—and yours. Mystified? Stay tuned for an explanation. PS: The wheels in your head are already turning a bit faster, aren't they?

“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.”
F. Scott Fitzgerald

Reference: Imagining dialogue can boost critical thinking: Excerpt: “Examining an issue as a debate or dialogue between two sides helps people apply deeper, more sophisticated reasoning …”

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