When I decided to become a Pediatrician in 2016 and apply for Pediatric Residency, I had no idea my potential. Fast forward to finishing 3 years of training and shooting out into a Brand New World, I wandered into a realm of locum tenens, and still I had no idea my potential. Move along again to 2023 when I realized I had not only paid off my >$300K loans and simultaneously saved almost about 50% of a year’s worth of a general pediatrician’s salary in retirement in less than 3 years, and I finally realized my full potential… Limitless.

The residents and medical students that I have worked with and taught over the years as a locum tenens have been privy to some *wild cannon* advice – sorry, not sorry for the transparency. I love teaching medicine and the nuances of understanding physiology to cure and to heal humans; however, it is one of the lesser interesting parts of my life or what I nowadays have to say. I impart my humbled experiences with business, the job market, and career goal mixed with a new vision of the future and the capacity of each of us to extend much farther than dreams ever thought they would take us. The whole idea of “shoot for the stars because even if you fail you will land on the moon” has become outdated for myself. At this point, I shoot for other galaxies and if I don’t make it, I WILL land on a star.

Some time ago, I was describing my situation to my mom’s husband on how I had an epiphany one day while working locum tenens. I no longer wanted to think outside of the box, I wanted to redesign the concept of the box in the first place and reconstruct anything that defined a boundary on any level. We have very little in common, but one thing he mentioned in response has resonated with me on a fundamental level: The story of bullet holes in WWII airplanes.

Really a conversation about a statistician on something called survivor bias, the story turns to an Austrian man named Abraham Wald. As the story goes, during WWII the US military sought to improve the outcomes of their aircraft that returned from war by strengthening their armor against lethal damage from enemies. The planes that returned had bullet holes in the wings and the tails, so they concluded these were the areas that needed reinforcement; but then, Mr. Wald stepped in and suggested the complete opposite: reinforce the engines. Long story short, the idea was that the bias of looking at the survivors, missed out on what had happened to those that didn’t survive, or something like that – I’m not a statistician, so that’s my laymens understanding of it. But understanding Bias is not the point of this post. Instead of looking JUST at the survivors, he suggested a bigger vision to look at the WHOLE and by doing so found a critically important point of improvement – maybe one of the original QI (Quality Improvement) epitomes for my mind. But, outside of the obvious discussion of survivor bias, the bigger point that stuck with me was that he looked at things from a completely different view and while most people were trying to solve problem A, he was rewriting the problem in the first place.

Month ago on one of my several airplane rides, I sat next to a man that was a data scientist. I still am not quite sure what it means or what exactly he did, but from the way he carried himself, the eloquence he conveyed and honestly, his clothes, I gleamed it was something very important and successful. He told me that he had grown himself over the last few decades into a spot of being paid to go places to give talks on behavioral marketing. Basically, you know when you come to this blog or you log on to social media and the internet tries to sell you stuff? I think he is the brains behind the internet doing that. I’m pretty sure he’s secretly watching right now even… Hi dude! He told me of something called the OCEAN Big 5 Personality Test. The 5 factors of the acronym are: Openness, Conscientiousness, Extraversion, Agreeableness and Neuroticism. Essentially a way to look at the perspective that people have in approach to their lives as well as the control they have in it. He isn’t thinking about WHAT someone bought today, he’s thinking about WHY they bought it.

I have tried to Google the question, “How many moves can Magnus Carlsen think ahead?” One of the most incredible chess grandmasters in history, some forums suspect 13-15 moves, and some more than 20. He can see the future in some regards, but really, he is assessing from multiple levels the bigger picture. He isn’t confined to one move ahead and the realm of what others can see. He can see beyond what anyone else can see to something that is all encompassing of the world. Inside of his mind, I believe, are algorithms and equations that the rest of us can’t even begin to write.

The point of all of those stories is simple, I no longer want to think “outside the box.” I instead have grown to question if there even IS a box in the first place. I encourage the learners I teach to think beyond everything. To think beyond today, think beyond this one single patient, or this one single purchase and to grow bigger. I have no idea where the future will take me and I sometimes grow stagnant with stability and rational thoughts, but, I hope one day to exist so existentially that I no longer even know what a box is.

Image Credit: https://philmckinney.com/ingenuity-action-3-companies-inspire-us-think-outside-box/