“Any questions for us?”
Ah, the dreaded interview question! This time I was prepared; the program was new with just one resident class to share the call burden. Because of that, I inquired about the configuration of the call schedule. The interviewer smiled, gave a vague answer and followed it with a diatribe about how present-day residents have it so “easy.” How his generation had to “walk through feet and feet of snow” to get to work and how work hour restrictions did not exist. Caught off guard, I wondered what sparked such an emotional response to a common interview question. Maybe he fielded this question too many times, was exhausted by residents’ complaints about being on-call, fostered resentment over his own residency experience or was disappointed with the quality of modern-day training. Maybe he had genuine critiques regarding the capacity of “millennials” and “zoomers” to deal with hardship.
A couple of months after the incident, I learned about sociologist Ibn Khaldun’s cyclical theory. He argued that the history of civilization was cyclical. Tribal people living in harsh environments at the periphery of civilization were toughened by their hardships in a way “civilized” folk were not. These nomads lacked the knowledge and culture of citizens and were often in conflict with other tribes. However, when the time was right, a charismatic leader would unify them and lead them to victory over the weaker civilized people. The conquerors would settle down and with succeeding generations become accustomed to the “easy” city life, which weakened their disposition resulting in their own defeat at the hands of a new group of unified tribal people, continuing the cycle. Ibn Khaldun may have argued that I was weakened because of the leisure I live in as the result of my nation’s efficient bureaucracy, division of labor and advanced technologies. As a result, even minor inconveniences or “first world problems” sometimes feel incredibly difficult, which is disappointing since they are so minute relative to the hardships of many people in the past and present. Maybe the interviewer is right that as a generation, we are unable to handle the same difficulties and work hours that residents of the past could.
Yet, I feel this conclusion minimizes the unique problems that come with modern leisure. Dependency on luxuries is a challenge and combating them helps to develop strength and resiliency in its own way. A middle school student must finish his homework on a computer that is just one click away from incredibly immersive distractions while also having to face challenges of bullying and trials of self-esteem that permeates into all aspects of his life through constant access to social media. Similarly, I had to combat the urge to distract myself on the internet or watch Netflix as a medical student when time was precious, and every minute spent studying mattered. On top of that, our stimulus-heavy environment has overwhelmed our brain’s reward system with dopamine to such a degree that it may be contributing to depression, anxiety and other mental health disorders in a way never seen before in history. Similarly, the social dynamics and traditional support systems people relied on for well-being a few generations ago have changed — family structure, child rearing, religious practices, etc. In addition, work-related challenges have evolved, including note-bloat, the complexity of hospital systems, the ever-growing body of knowledge in medicine and the need for increased medical specialization. Much of the above is a byproduct of progress; the result of technological and societal innovation to solve our forefathers’ problems. Yet, as the philosopher Isaiah Berlin argued, amongst the scheme of progress the very solutions become the source of new problems. The medical students and residents of today have a whole set of different circumstances and challenges than those of the past. It is unfair and probably impossible to quantify the differences between generations. Instead, I think the comparison is useful to reflect on how the world has changed; we can realize the beneficial changes while identifying the negative aspects.
I also began to reflect on how I think about comparisons and the words I use to describe them. I did not realize the reductive potential of descriptive words like “easier” or “harder.” These words are in essence one-dimensional, subjective and possibly confining. The interviewer may have seen changes and interpreted them to be easier while failing to account for all the other unique challenges. Similarly, I noticed my inclination to oversimplify the way I analyze events. I feel as though I reduce situations based on the ideas, emotions and beliefs I already carry. I see each experience through a lens that has already been consolidated. However, the sole purpose of this lens is efficiency, not correctness. By maybe accepting that this reductive lens exists is the only way to challenge it.
The one thing I have great confidence in is that struggling is our reality no matter how our culture changes. Even as we maximize our comforts with the addition of new devices, those devices will be a source of our angst. Too much of a “good” thing is “bad” — it makes us weaker in the Khaldunian sense and overwhelms us with dopamine, altering our brain’s reward system. We need to feel “bad” to experience joy and happiness and give us strength and power over our struggles. Our negative emotions are therefore a necessity. Furthermore, just like the civilization cycles of Ibn Khaldun, emotions themselves are temporal and give way to each other. That gives me hope during difficulty because I understand that it will end and that better times are just around the corner. Understanding this necessity and the temporality of negative experiences allows me to rationalize struggle, which then allows me to build resiliency. Reflecting and focusing on the positive aspects of life further establishes endurance as gratefulness allows me to be content for a longer stretch of time.