During a recent lunch, a dear and trusted friend asked me to list the decisions that I have made over the past 30 years, which, in his view, led to a successful career in teaching and practicing dentistry. He is the one who met me when I was a very green immigrant “fresh off the boat” with no qualifications — he witnessed, actively participated and guided in many of my activities over the past three decades. At first, it was easy for me to pick the four major forks in the road and name the right decisions I had made at those junctions. On second thought, however, they were steps taken in circumstances created by turns of events not entirely under my control and thus could be considered under the heading of ‘being at the right place at the right time’ (i. e. being lucky) and making the obvious decisions (i. e. being smart). Looking at it this way, it appears that I have made only good decisions and may just finish the perfect “game” in a decade or two.
Walking back from lunch with a “glowing halo” around my head, an uneasy thought appeared. I wondered whether I made any wrong decisions along the way, and if so, what were they. Had I made decisions that may have derailed my career or kept me from achieving more?
Back from lunch I quickly assembled an embarrassing list of bad decisions. Looking at this list, my career appeared to be one of missed opportunities and unfulfilled potential.
Later, in front of my dear and trusted computer, I reviewed the stepbystep intraoral pictures taken during a procedure completed by our residents in periodontics. I do this routinely (I call it “nearreal time imaging”) with the cases I supervise and, to a lesser degree, with my own cases in private practice. It appears that during these procedures we make a string of decisions: good decisions and bad decisions, that lead, in the overwhelming majority of cases, to what is considered successful treatment outcomes. Luckily, in dentistry today, we achieve excellent results with high degree of predictability. On final analysis this is possible because making mostly good decisions at various junctions during an implant surgery for example. So, if we look at the good decisions only we get a “glowing halo” around our heads as many speakers on the “circuit” have them. Almost always though, my “timelapse pictures” that trace the multitude of steps taken during the surgery show steps that could be considered not so good and perhaps outright wrong but still leading to a successful outcome albeit smeared by the smell of unfulfilled potential. So, if we look at the bad decisions only, we feel guilty.
Reading the magnificent book by Rohinton Mistry (McClelland & Stewart Ltd., 1995) entitled “A fine balance,” I realized that the title said it so well. The book traces the lives of four unlikely people as they struggle to maintain a fine balance between bad and good, hope and despair in the turbulent times of the mid1970s India.
Next time you review a case report, critically assess your finished cases or listen to a famous speaker with a “glowing halo” around his/her head, perhaps remember this concept of a “fine balance.” Achieving it by navigating the road of good and notsogood decisions during a small procedure or over a full career, and then balancing them towards a favourable outcome is what it is all about. Before starting to develop a “glowing head” from suc cess, or blaming yourself un fairly, we should ask ourselves whether we were able to reach a fine balance?
