Friday 17 August 2007


It occurs to me, having seen a lot of colleagues and students over the years with a similar trait, that I am not alone in being a touch obsessive.

Just a touch. I'm not talking about obsession that meets the World Health Organisation's rather splendid Internaional Classification of Diseases (ICD-10) diagnosis for F60.5 Anankastic Personality Disorder or for F42.0 Obsessive Compulsive Disorder with Predominantly Obsessive Thoughts or Ruminations. I'm talking 'bout just a touch of being more meticulous and fussy and obsessive than necessary.

And this trait is surprisingly common in medics.

It can be annoying. I knew a scrub nurse who'd bemoan a surgeon who always has things set out "his way" and another who does it differently for the same procedure. She gave him the instruments, what did it matter how it was set out on her tray? It mattered to the surgeon. It had to be done just so in order to be right. I've work with an anaethetist who aligns stationery in out patient clinics (and will re-align pencils and paper if it's not all in place).

Small things. People wanting to have influence over their working environment. Nothing too neurotic or compulsive.

But I don't tend to see the same in the local supermarket, in my local garage, or even from one of the three solicitors I was recently paying when moving house. And I've sadly had to spent a lot of hours in all three locales!

Medicine maybe attracts those with obsessive traits. But since we enter medical school at a relatively young age, I'm not sure that people are self selecting for a career in medicine because it will suit their temprement.

I think it's more likely that medicine inculcates obsessive traits.

It's a good thing.

When a patient is wondering what's wrong with them you want a medic who's thinking, "What were the results of Test X and do we now need to do Test Y and Scan Z to exclude conditions A, B and C?" You want someone thinking, "It is unlikely, with only 3 cases reported in the UK ever, but it could fit so we better exclude Condition Blah." When a referral gets lost in the internal post, when a result isn't 'phoned through, when a GP's not been told of interventions isn't it great that medics are obsessive enough to check out and 'phone up to "sort things out" and make sure all is well?

I think so.

Not being meticulous, not making sure everything is done, not checking . . . being very relaxed and cavalier about it all is not reassuring to me.

Which is why I think being a touch obsessive, although potentially quirky or eccentric, is healthy. It means checking, it means getting things done thoroughly and getting them done right. If my wife or kids need to see a doctor I'd rather they saw someone who was also a touch obsessive!


The Girl said...

Me too, on all counts. Being obsessive has saved my bacon at work many times prior to becoming a medical student. When I'm a doctor, I have no reason to think that a reasonable amount (i.e. still able to function!) will be anything but a good safeguard.

Milk and Two Sugars said...

The flip-side of the tendancy towards a profession of obsessiveness is that when we encounter a medical student or doctor who doesn't have a drive to make sure that every detail is just right, we can consider them insufficiently motivated. I certainly don't respect medical students or doctors who, in my own words, "can't even manage to arrive on time" (there's a definate negative connotation to that phrase).

On the other hand, as someone who lies between a diagnosis of F60.5 and F42.1, I'd add that all my traits were firmly in place by early adolesecence. I'd put forward the view that students capable of achieving the marks required to enter med school are often obsessive studiers or very good rote-learners, which necessarily sets them up for the thought processes required in practicing medicine.

Spirit of 1976 said...

During my nursing degree I was bumping up my bursary by working weekends as a support worker to autistic children. Much of what I was doing involved trying to break the ritualised behaviour that a lot of these kids had.

Something that I noticed in myself when trying to teach the children that they don't *have* to do things in a specifical, ritualised order, was that I had my own little rituals that I was doing myself.

For example, when we picked up the child from his parents' home, I'd open the door, put his bag on the seat beside him, then close the door for him, even though he was capable of doing it himself. My colleague pointed out that the child was expecting it as part of his rituals, so I decided to make him do it instead. Surprisingly, it actually took several weeks for me to stop doing it automatically as part of my own little ritual behaviour.

I guess we're not just all a little bit obsessive-compulsive, but we're also all a little bit autistic too.

Calavera said...

I love this post, and I totally agree.

I used to think it was the other way around. I used to think that it was all the weird, obsessive people who applied to medicine.

I never even stopped to think that maybe it's some sort of natural sorting process that occurs. Of course doctors need to be meticulous and obsessive.


So now if someone tells me I'm being weird, I'll just say that it's medicine that made me like that!

Calavera said...

Re-reading this now - brilliant post, I still agree.