The Difference Between Easy And Difficult

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After meeting with an attending physician in a Physical Diagnosis class when I was a second-year medical student, I remember thinking how impossible it seemed that my brain would ever contain as much medical knowledge as his.  And even if somehow one day it did, how would I ever be able to call on it, manipulate it, twist it, bend it, and turn it upside down with the same apparent ease as he? Each new fact I crammed into my weary brain seemed to increase the pressure inside it as if it were an expanding balloon, making each subsequently fact even harder to squeeze in.  I sometimes worried my brain would actually pop.  It was just unbelievably hard.

And yet today, more than twenty years later, I routinely see ten to twelve patients in four hours and navigate their medical complexities with relative ease.  What feels hard now is arranging tests in a timely manner, returning all my messages, conferring with consultants, pleading with insurance companies, and documenting everything my patients say and I do.

At least, that’s what feels hard sometimes.  On the other hand, sometimes not.  Just what are these two animals, easy and difficult, and what makes them so?

EASY

On the surface, easy is what we already know how to do or that which takes little mental or physical effort.  It’s easy for me to figure out when a patient has heartburn rather than coronary artery disease when she tells me she’s experiencing burning under her sternum associated with a sour acidic taste in the back of her mouth that occurs reproducibly after meals and when she lies down.  It’s easy for me to read entertaining books, to go to a movie, to eat a tasty meal.  Easy produces no strain, no stress, no fatigue.  Easy is enjoyable.  Easy is what most of us want most things to be.

But, then, easy produces no growth, no improvement.  Easy offers no protection against decline or disease.  Easy produces little or no accomplishment.  Too much easy sees us grow soft and even less capable.  Easy may be pleasant, but pleasant is only part of the equation for happiness.

DIFFICULT

On the surface, difficult is something we don’t yet know how to do or that which takes great mental or physical effort.  It’s difficult for me to figure out what’s causing a patient’s abdominal pain.  The signs and symptoms are often vague and the differential diagnosis (the list of possible causes) is broad.  I really have to think.  Also, it’s difficult for me to exercise.  It’s difficult for me to write when I don’t know what I want to say.  And it’s often difficult for me to figure out what I want to say.  Difficult wears me out.  Difficult sometimes stresses me out.  Difficult hurts.  Difficult is often not fun.

But difficult makes me grow.  Difficult makes me improve so that what was once difficult becomes easy (bench pressing 200 pounds was once hard, but now it’s easy—er, less difficult).  Difficult makes me feel good in a way easy doesn’t.  It’s not exactly pleasure but more like satisfaction.  Difficult keeps me sharp, ready, and capable.  Difficult makes it more likely I’ll live longer and be healthier while I’m alive.  Difficult is often (though certainly not always) more interesting than easy (for example, when it comes to a good story, you don’t want the hero to win the girl on page one, do you?).

THE REAL DIFFERENCE

What really makes things easy or difficult, of course, is us.  Our own inner life state.  When we’re tired, depressed, or distracted even easy feels difficult.  And when we’re buoyant, energized, confident, and eager difficult feels easy.  Many of us spend an inordinate amount of effort trying to avoid difficult.  But what we really should be doing is seeking to strengthen ourselves so that difficult is doable.  We shouldn’t run from difficult.  We should embrace it.  As John Kennedy famously said, we didn’t go to the moon because it was easy.  Not to imply easy is bad or that we shouldn’t enjoy it—just that an easy life isn’t only impossible; it’s undesirable.  Neither the human body nor the human mind were meant to be put in a corner and left unused, and using both requires effort.  And effort feels difficult.  But effort rewards.

So which is it to be?  Easy and fun?  Or difficult and satisfying?  Both are important to a happy life, but what’s the right ratio for you?

Next weekThe Caregiver’s Manifesto

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  • Yay for who you are and what you write.

    I needed to read your article just at the time I read it.

    Thank you, thank you and thank you.

    Grace

    Grace: You are so welcome.

    Alex

  • In other words challenge yourself and continue to develop yourself in all areas of your life, otherwise there’s no growth. This is timely because today I wanted to pop in a movie and watch it but since a paper for one of my classes is due, I drove to the library, spent the entire afternoon there and finished it. Now I can do a little easy and watch the movie.

  • Forgive me for playing devil’s advocate, but are there not more permutations? Mustn’t fall into a Manichaean divide!

    I took my first Trager movement class today and learned that “no pain, no gain” might not always be correct. Sometimes we should find the “easy,” painless way to move, and that might be more correct than brute forcing it.

    Perhaps as with Tai Chi or Aikido, the way of water—fluidity—might not be a cop out, but the most efficacious method. I agree we should endeavor to grow and expand, and oft times pain becomes a good teacher, but perhaps growth and satisfaction can be had sans difficulty?

    Just a thought…

    Lisa: I think there are different kinds of pain: the pain of growth that’s painful precisely because it’s difficult, and the pain of injury (I tend to think in weight-lifting metaphor…) that should certainly be avoided. My real point was not just that easy and difficult are subjective experiences, that obviously what one finds difficult another finds easy, but that easy and difficult depend as much on our inner life state as on the activity itself. I’d love to think that growth and satisfaction (from accomplishment) can be had sans difficulty but I’ve never experienced it that way personally. Perhaps others have?

    Alex

  • Alex:

    I love this.

    As I’m sure you know, one of our employer’s leadership objectives is to “make practice easier” for physicians.

    While on the surface I agree with the sentiment (who doesn’t want their work made easier?), it’s got me to wondering rhetorically what that would even mean…

    More automation?

    “Easier,” more adherent/compliant patients?

    Better “throughput?”

    When I really boil it down, it seems that making life (work and play) better is the more important value than making it easier. And at least as far as work goes, better involves improving the communication between us all—rather than just keeping us in our places and documenting into the abyss.

    Easier said than done!

    John

    John: I completely agree. “Better” is a better goal than easier. Nicely put.

    Alex

  • Interesting that I read this today because I’ve been feeling like my job is “too easy.” I have the same boring duties day in and day out, no challenge. I’m looking for another job but not having any luck. Perhaps if I took on some difficult and challenging work (that I have frankly been avoiding) I wouldn’t be as unhappy and I may find myself more satisfied with my job. I think you are trying to tell me something.

  • Alex,

    Your wonderful article (with impeccable timing) gave me the energy to deal with all the difficulties I face.

    THANK YOU

    Eric

    Eric: You are so welcome.

    Alex

  • I really love your articles ‘cos they are so meaningful. This post is especially pertinent to me because I had just changed my job scope and am currently struggling to learn the ropes. It is tempting to give up when everything feels so overwhelming at times.

    But I think being subjected to fresh challenges everyday means lots of mental stimulation and this keeps me alert and awake. I go to work wondering to how achieve the desired results and when I managed to overcome difficulties, the feeling is exhilarating. My self-esteem and self-confidence increase and I feel proud of myself. I will never enjoy the sense of achievement if I give up too easily. I would like to share with you Robert Frost’s poem:

    Two roads diverged in a yellow wood,
    And sorry I could not travel both
    And be one traveler, long I stood
    And looked down one as far as I could
    To where it bent in the undergrowth; 5

    Then took the other, as just as fair,
    And having perhaps the better claim,
    Because it was grassy and wanted wear;
    Though as for that the passing there
    Had worn them really about the same, 10

    And both that morning equally lay
    In leaves no step had trodden black.
    Oh, I kept the first for another day!
    Yet knowing how way leads on to way,
    I doubted if I should ever come back. 15

    I shall be telling this with a sigh
    Somewhere ages and ages hence:
    Two roads diverged in a wood, and I—
    I took the one less traveled by,
    And that has made all the difference

    JM: One of my favorite poems ever.

    Alex

  • As a second-year medical student who is dealing with the last weeks of lectures and exams before boards and wards, your article provided me a boost of reassurance; I really needed it today!

    Elena: I remember that time well. Hang in there! It only gets better, truly.

    Alex

  • Dear Alex,

    A piece of advice I have always found helpful is “Do the hardest thing first.” Accepting that a task is difficult and yet needs to be done seems a key part of daily mental health for me. Reading your essay helped me better understand the state of mind behind facing a difficult task. Thank you for your insights.

  • Great read, however I noticed something at the top of your page after I read the article:

    “New posts are available every Monday and can be read in under 5 minutes.”

    Is there a reason to let everyone know upon entering your site that it only takes 5 minutes (aka it is easy) to read your articles?

    🙂

    Sean: Ha! Nice pick up. Research has shown people prefer their Internet browsing and reading in short, staccato bursts, so I put that message up to make my articles seem less intimidating (and as a reminder to myself to keep them short…er, shorter).

    Alex

  • I want to thank you for posting such uplifting information on your blog. This year has been incredibly difficult for me so far, and your blog has been a place of encouragement.

    Stephanie: Your comment encourages me! Thanks for taking the time to post it.

    Alex

  • Thank you so much for this thoughtful post. It is just what I’ve been trying to sift out in my own mind at this very point in my life, without really being able to properly explain to myself. Yes, yes, yes.

    I really appreciate this piece—well, every one, as I read it every week. As you can see, I’m a week behind at the moment.

    I think you answered some questions I have about the future. I’m grateful for your point of view.

    Mimi: I’m glad you’re finding them helpful.

    Alex

  • Alex,

    I agree “growth and satisfaction (from accomplishment)” can probably not be had sans difficulty. Everyone seeks comfort and to not rock the boat; we prefer bad knowns to the possibility of better unknowns.

    A little tree frog living in my outdoor garbage can proved that to me yesterday.

    I have tried for a couple of weeks to get him to vacate, yet he grows paler and paler, and surely the once-weekly pickup must be a traumatizing thing. And it smells bad, but—he has a roof over his head, and some kind of food, even if it’s not the best for a frog.

  • Alex:

    Am totally enthralled with the content of your writing—and also how you write!! I look forward to receiving your weekly posts…and even send them to people I know who will definitely appreciate them.

    Having been a Buddhist for 36 years, I have had to challenge my life constantly when difficulties, obstacles, and sicknesses arise…and I always win!!

    Thank you for your great words and thoughts.

    Maxine

    Maxine: Thank you.

    Alex

  • Alex,

    Great post and right on as usual.

    Sometimes for me the “hard” part is simply getting something started. After that it is relatively “easy” to continue on task and finish. Maybe it is just inertia that is the problem. You might add “I’ll just do it later” as a third option to hard or easy.

    Only need 35 more hours of Category 1 by the end of this year, gotta get busy on that…and then there is learning Japanese in my so-called spare time (konichiwa!)…and…and…you get the idea.

    Steve