Do you stop reading a book when you find it less than fulfilling, even though you have not finished it?
I rarely do, but one of the books that I got for the holidays, that I was anticipating, was just not enough to hold my interest. I knew it by page 4, and at page 50 and even half-way through. Moreover, for the first time, in a very long time, I just put it down. Even though I had savored it before it arrived, it was just not for me. I guess my ‘sunk-cost’ sense to finish what I start overwhelms opportunity costs*. (I am trying to flex that MBA vocabulary)
What about those thick books, you know, the ones that are two or three inches thick?
We are talking about a big commitment. I got one of those books and at about 2/3rds of the way through, I began to feel my intention wander. It was a book about Genghis Khan, whom I know so little about, but after awhile there is only so much plundering, sieging and despoiling you can manage. For that book, I persevered a bit longer my attention returned, and I reached the book’s natural end.
I mention both of these reading ‘events’ because these responses frequently express my clinical choices. My love of the big, complicated case, the one that was 4-6 hours in the OR and a night or two at the bedside, the epic case – not so much anymore. I can do it, but I am more inclined to pass it along to a younger version of me. I find the same gratification in the ordinary case, done well. I have done the epic case, but like the epic read; I find myself sagging a bit in the middle, so I have become a bit more selective in my choices.
My ability to juggle opportunity vs. sunk costs has changed for my clinical patients. I am less willing to pursue the dead end, less inclined to view it as the false start. It is not, at least in my mind, that I now persevere less, but that I perhaps empathize more. Salvaging an unusable leg with hours of surgery and month of care has no value for my patient. It is tough for a surgeon to acknowledge defeat, because of our direct investment and the short time frame in which everything can fall apart. Surgeons expend more time on what turns out to be futile cases when the cases are elective when they know and have relationships with the patient; when surgery is emergent, and the patient is unknown to them we cut ‘our losses’ earlier.
So is my need to finish the book a result of my training or is just an inherent part of whom I am manifesting itself not simply in my reading but in my clinical care?
*Sunk cost - a cost already incurred that cannot be recovered e.g. the time I have spent reading the book. Opportunity cost - the opportunity lost doing another activity e.g. what I might have done instead of reading that book.