The Healthcare Worker Ego Trip: A Blight of Epic Proportions - Part 1

As-salamu alaykum,

Have you ever been involved in the care of a patient and felt an exaggerated sense of import for the role you played in the care delivery pathway? Was it a clinical insight that you offered, a procedural or surgical intervention, an administrative facilitation to expedite a patient transfer, a listening ear to the anxious family members or even an encouragement for the patient to get out of the bed that impacted discharge planning in favor of home with home health rather than to a Skilled Nursing Facility?

And you felt good about your contribution - and maybe even borderline gloated about it among peers or in a multidisciplinary team gathering.

Regardless of the role you played, tangible or otherwise, appraising your “success” with regards to the index event solely within the paradigm of the self is a slippery slope and yet it is rife among our ranks as healthcare workers.

I was on a hospitalist shift recently and got pulled into the back end of what was for all intents and purposes a successful emergent patient transfer for a higher level of care in order to diagnose (but not necessarily address) a possible procedural complication that happened prior to my arrival. 

My role was simple - get informed - of the clinical scenario and be prepared for a possible reverse transfer back to my facility for a potential emergent procedural intervention to salvage the situation. 

I sensed a gap in the narrative that directed decision-making to the hospitalist with limited involvement of the proceduralist. 

The “game plan” was updated to place the proceduralist appropriately at the center of the communication with the diagnostics team of an emergency medicine physician and a radiologist to ensure firsthand transfer of information that would get the patient taken care of in the quickest and most optimal manner.

As you can tell, I was the hospitalist. The one that addressed the communication gap. Over the course of the shift, we found out that things went as planned with regards to communication and the patient was ultimately taken care of at the tertiary healthcare center. 

Other ancillary healthcare colleagues were quite pleased that the plan of care was updated and that a reverse transfer was avoided. I also shared the sense of relief. 

At the same time, I noticed a sense of inflated self importance (albeit subtle) that creeped into the “post-mortem” conversations. It was this thing that healthcare workers, especially higher up the totem pole, experience - the Ego Trip. May Allah, the Most High, protect us all from it even in its slightest form. Amin.

I was disappointed. I was also thankful that I was able to catch it before it deteriorated. Alhamdulillah.

Sadly, this is intimately familiar to all of us. 

The mainstream discourse about this traces its roots back to the competitive narrative of our healthcare educational experiences, the struggle to make it into medical school, and in some parts of the world, to stay in it and it continues through the journey for residency and fellowship and the list goes on.

Eckhart Tolle, in his book “A New Earth: Awakening to Your Life’s Purpose”, wrote about this subject - “the egoic mind is completely conditioned by the past and its conditioning is twofold — based on content and structure.”

That past for us is the many years of our healthcare educational journey. 

He further explained that “the content you identify with is conditioned by your environment, your upbringing, and your surrounding culture.” 

There’s a lot to be said about the healthcare environment in this regard and the impact it has on all of us. Thankfully, there’s slow but important work to remedy the historic patterns related to these issues.

In today’s discourse among healthcare workers, it doesn’t just show up on the hospital floors but has expanded its reach to our messaging applications from the ubiquitous WhatsApp channels to social media platforms impacting our clinical debates as much as it does our non-clinical discussions on issues such as Politics and Gaza, more recently.

So why should you and I be worried?

Allah, the Most High, addresses this in different ways in the Quran. Consider the following verse; 

Surah Al-A’raf, verse 146: “I will turn away from My signs those who are arrogant upon the earth without right; and if they should see every sign, they will not believe in it. And if they see the way of consciousness,¹ they will not adopt it as a way; but if they see the way of error, they will adopt it as a way. That is because they have denied Our signs and they were heedless of them.”

The Ego Trip is a shade of arrogance.  Allah describes the repercussions here highlighting that He will disconnect the arrogant from what should be obvious from His signs such that they do not perceive or acknowledge them.

The arrogant, instead, stall their own mindfulness of Allah, the Most High and the opportunity to cultivate spiritual intelligence that can sharpen the clinical acumen on one hand and improve our overall sense of wellbeing and resilience.

The Prophet Muhammad PBUH also explains this further in the following hadith; 

Abdullah ibn Mas’ud reported: The Prophet, peace and blessings be upon him, said, “No one who has the weight of a seed of arrogance in his heart will enter Paradise.” A man said, “But a man likes to have nice clothes and nice shoes.” The Prophet said, “Verily, Allah is beautiful and He loves beauty. Arrogance is to disregard the truth and to look down upon people.” [Source: Ṣaḥīḥ Muslim 91]

How often do we not listen to colleagues when they have a differing perspective on an issue and we stick to our unipolar framing driven by a number of confounding factors from our specialty specific lens to our recency biases only to limit the potential for a successful patient outcome or improved collegial relationships that acknowledges our different lenses and the true source of success, Allah, the Most High.

Ellie Fossey said in a paper about interdisciplinary team dynamics in healthcare; 

“There are real power and status differences between the professions as well as in consumer-professional partnerships, which may mitigate against valuing each others’ perspectives, and building respectful relationships with consumers and among team members.”

We all recognize that healthcare is a team sport yet we do not invest enough energy and focus on addressing this at a personal and systems level.

This blight of epic proportions has ramifications that impact clinical outcomes for our patients, healthcare worker wellbeing and, as Allah and His prophet PBUH alluded to, serious considerations that transcend this worldly life and carries over to the next.  

We pray that Allah, the Most High, enables us to recognize this issue within ourselves first and to make necessary commitments to meaningful progress in addressing it for our own wellbeing and that of the patients we serve as well as our colleagues who serve alongside us on our healthcare teams. Amin. 

In sha Allah, next week, we will explore practical steps to help us on this journey of taming our egos and better aligning ourselves with Allah’s will in this regard. 

Before I let you go today, here’s an important growth opportunity to consider. 

In the spirit of the upcoming transformational season of Hajj and the best 10 days of the year, I am sharing a remarkable high-impact course offered by my co-certified partners with the Productive Muslim Company, “The 10 Habits of Highly Productive Muslims”. Check it out in sha Allah.

Sincerely,

Sulyman