Thursday, November 27, 2008

A little bit of OCD

Today, several of my friends were with me at my locker as I was getting ready to proceed to the library. While we were conversing, they noted me carefully folding my scarf in half, ensuring that both ends were equally just so, before swinging it around my neck and passing it through the loop (European style). They found this need to make certain that both sides were equal was most peculiar and thus commented that I had a little bit of OCD (Obsessive Compulsive Disorder).

I replied, as I tend to do, that we must all have a little bit of OCD or else we would not be where we are today (that is, in medical school). Some of these friends understood and agreed but the others found this statement quite queer (and I don't mean so in a modern sense, but rather in the original meaning of the word - that is, quite strange). Now, I should stop and make clear that I did not mean this as an insult in the least (i.e. if you do not have a little bit of OCD you do not belong), but as a statement of fact - that irrespective of whether my peers recognize it or not, there is a little bit of OCD, as I define it, in all of them. Let me explain.

Obsessive Compulsive Disorder, as a pathological process, is as I perceive it, simply an obsession with perfection. OCD, in a clinical sense, is such an obsession that it overtakes your life and prevents you from going about your daily activities. A person with OCD might wash their hands until they are raw or check if the door is locked, and then recheck, and recheck a hundred times. Neither the act of hand washing nor the act of locking the door are wrong. In fact, they are good and proper procedures. It is the anal compulsivity of ensuring perfection, which overrides all other impulses, that makes it a disorder.

OCD on a mild level, then, would be a slight preoccupation with perfection. We may describe this as the "perfectionist" or the "Type-A" personality, though we almost never say this to mean that a person ought to be institutionalized or that they have some kind of significant psychiatric illness. The opposite of a Type-A personality adopts a laisse-faire style of being - letting things come and go as they were. They would not be preoccupied with marks and minutia, but would rather go about their business and let all other things fall as they may.

In order to enter into medical school, and indeed, into most other competitive fields, there must be a preoccupation with achievement that exceeds that of the ordinary person. Sure, it is key that one has the empathy and desire to aid as well. But such desire alone will not propel one to be a competent physician. Our obsession with knowing the right answer, our ability to learn and recite minute details... our tendency to read and reread, check and recheck - to not be satisfied with 70%, but requiring that 90% - has assisted in our attaining this position. (And it's only natural for such obsessiveness to spill over to other aspects of our lives in small ways)

[Edit: I do not mean to say that more easygoing persons cannot and do not achieve 90's, though in their case they would not be preoccupied with the attaining of the mark itself]

It is true that in the practice of medicine, these things will become less important. There will be greater emphasis on patient care, teamwork, and critial thinking; but these remain skills and character traits that each individual possesses. And that, my friends, I believe is a little bit of OCD.

1 comment:

sandlot said...

I'm OCD. You're OCD.

Let's scrub our hands a few times repeatedly and then hold each other.