I’m currently at a career junction. Thinking about which medical speciality to select has made me reflect on the process of ‘doing something very similar for a long period of time’. This article argues for the value in practicing something for an extended period of time, i.e. craftsmanship, and how it might be beneficial for direction, meaning, and opportunity.

1. Intro
2. How is the concept of Craftsmanship relevant today?
3. Four real benefits of finding a craft
– Vision and direction
– Access hard-to-reach areas
– Discipline and focus
– Competence and confidence create opportunity
4. On choosing a craft; what I’ve learned from medicine
– Be lead by inclinations, but allow chance
– Enjoy the ‘bread-and-butter’
– Learn about the ‘mini-games’

A world of multiple but dizzying options

We’ve not ever had the degree of occupational fluidity and transparency to each other’s lives that we have now. Most of us spend varying quantities of time across a number of jobs, and likely gain a lot from this exposure.

We also hold an immediate (touchscreen) window into what virtually every type of human across the planet are up to at any time. Social media feeds present us with a homogenous ‘other’; a highlight reel of outstanding achievement spanning niche domains that our brains struggle to differentiate as specific individuals. Instead, we subconsciously see ‘us’ and ‘others’, and fall into an unforgiving game of binary comparison.

Being subconsciously pitted against the curated content of outliers across unlimited domains is a brutal competition that I lose every single time.

The sensation of paralysis that results from this means that we can potentially flit from one thing to another. Pulled in all directions, its hard to know where to settle and double down, since a distracting ‘have you thought about this?’ is always just one finger scroll away.

When, in human history, have our minds ever been exposed to such a density of extreme human abilities and competencies as now? A ten second scroll through instagram probably reveals more outlier activity than someone living one hundred years ago would see in their entire lifetime.

How to cut through the noise and distractions, to focus on our own individual journey?

It is not that long ago that guilds and apprenticeships provided a potential roadmap through life for many young people. A well-defined pathway toward mastery, with recognised standards and norms to plot one’s course by. Those who excelled were even able to alter parts of this journey with new discoveries, and merge tradition with their own individuality to create a unique type of craftsmanship that could define them for centuries; Leonardo Da Vinci, Wolfgang Mozart, and other virtuosos.

This is not to say that we should be hot-housed in gymnastics schools from the age of 3. There is evidence that specialising too young can be absolutely detrimental to lifelong development. And whilst modern connectivity enables us to consider infinite potential activities and lives, I wonder if this exposure can sometimes mutate into overwhelm and split us across all directions at the expense of meaningful progress in, albeit, fewer paths.

How is the concept of ‘craftsmanship’ applicable to our lives now?

Around two years ago, despite financial and future uncertainty, my brother resolved to leave his job as a social worker, and enrolled in furniture making school to formally pursue his passion for woodwork. For nine months he spent up to twelve hours a day in the workshop, learning dovetail joints, using hand tools, the characteristics of different woods, and the process of transforming a sketched out notion to a fully realised, crafted furniture piece.

He has found a direction that resonates with him, with multiple layers of a craft to master; the tools, techniques, materials, relationships with clients and colleagues, workflow…everything.

My brother doing wood stuff, check out his work

A relevant definition of Craftsmanship?

I’m arguing that ‘craftsmanship’ can be found across almost all domains and activity. The point is less about the specific activity, and more about the approach to the activity. I’m more interested in maximising the accessibility to benefits inherent in a ‘craft’ mindset. Richard Sennett, author of ‘The Craftsman’, would echo this:

‘Craftsmanship names an enduring, basic human impulse, the desire to do a job well for its own sake. Craftsmanship cuts a far wider swath than skilled manual labor; it serves the computer programmer, the doctor, and the artist; parenting improves when it is practiced as a skilled craft, as does citizenship.

In all these domains, craftsmanship focuses on objective standards, on the thing itself.

As I see it, some of the defining characteristics of a craft include:

• An ongoing process of deliberate practice
• A direction of practice
• A set of standards to aim for and compare against

Many pursuits can be undertaken with these points in mind; cooking, dance, writing, speaking, barista work, personal finances, law, DIY…etc. The first step is in finding something that resonates, even a little. We have our own inclinations and things that interest us, and leaning toward those is an initial step.

Its strange that we often can’t describe why we like something, or feel attracted to something, but somehow we do. You like certain paintings and music more than others. Why? I have no idea, but at least we can use that inexplicable leaning toward certain things over others as a guide. Staying still isn’t an option, as time passes anyway. You pay a price for doing and not doing:

“You’re going to pay a price for every bloody thing you do and everything you don’t do. You don’t get to choose to not pay a price. You get to choose which poison you’re going to take. That’s it.”

Jordan Peterson

Four real benefits of finding your craft

Sustained deliberate practice of something meaningful to the us may have more benefits than simply getting better at that thing:

Vision and direction

A craft can provide a kind of ‘vision’ that can be brought to the world. On walks, my brother sometimes pauses to discern what species of tree is next to him. Form and design can be appreciated across arabic script, shapes, natural materials, architecture, and imbued into pieces in the workshop. Textures and colours take on new meanings, and even his hands transform from functional anatomical parts into tools of a trade that can express ideas in solid works of art.

It was the same for me when I practiced parkour more frequently. Practitioners are familiar with the parkour ‘vision’ that converts rigid urban planning and design into virtually unlimited opportunities for challenge and growth, simply from a shift in perspective. A rail becomes a landing spot. A wall becomes something to grab and ascend. A scaffold set is now a swinging and climbing place. Every physical object is codified into interactive elements that are only limited by imagination or physical ability.

Our five senses and physical constraints mean we cannot be attentive to all of reality, and it can hard to know where to focus amongst the unlimited streams of information and possible next steps. A craft or practice installs a shift in perspective and vision, which is mapped onto the world and gives new direction. Bright spots of meaning and interest announce themselves to us amongst what can otherwise be endless, undifferentiated streams of information and stimuli in everyday reality. These bright spots direct our attention, interrelate, and constitute stepping stones for our own individual journeys.

Access hard to reach areas

There is something remarkable about observing a dancer, painter, olympian, musician, chef, or other craftsperson at the top of their field. In those moments when they are performing at the edge of their practice and ability, they are in a different ‘place’. They almost seem to occupy another plane or dimension to where we are, a place that we cannot enter, yet all recognise.

However, its not just world-class exhibitions of performance that enable a unique plane of being. People who commit to something for a long enough duration go to places that most do not. Firstly, the process itself of ‘practice’ has many parallels with the ‘hero’s journey’; there are doubts and difficulties to overcome, which oscillate with revelations, attaining new abilities and self-discovery.

Objective standards and existing role models within any field already provide an external measurement of your own progress and direction, exerting a gravitational pull from your current place, toward a place of ‘better’. Furthermore, a vision for the type of person you’d like to be, in part reflected in your craft, can help you strive towards ‘better’.

Standards, role models, and your own ideal can be three forces a craft can provide, which may be otherwise absent. They may actively spur you out of the ‘known’ areas of comfort and familiarity, into the ‘unknown’ places of growth and discovery. These invaluable areas are usually hard to reach due to the degree of consistency and challenge that are required to access them. A craft can constitute a vehicle for this.

Discipline and focus

The development of a craft inherently requires repetition, focus and consistent investment of time and self. Generally, the gap between ‘now’ and ‘better’ is bridged by time multiplied by deliberate practice. Meaningful progress will result from even a moderate amount of effort, undertaken regularly over a long enough time. In a world pulling us in all directions, a craft offers up a more defined trajectory that we can predictably ascend through consistent, deliberate practice.

The development of discipline and focus that inherently accompanies this process are attributes that are perhaps increasingly rare these days. The default state does not require any discipline or focus, but a craft provides the pathway toward cultivating these precious attributes. Combined with a vision, discipline and focus can constitute a formidable force that fuel you forward in life, away from feeling lost and toward things you see as meaningful.

Competence and confidence create opportunity

Competence cannot be argued with. It cannot be faked or gotten by shortcuts or tricks. It is a rare commodity that can only be earned through time, effort, experience, and practice.

Competent individuals have a unique grasp of visceral reality, because abilities or skills are reliably manifested across multiple iterations of time, space and contexts. Wherever they are tested, they can perform, and subsequently influence the reality around them. When we see this it is undeniable, and so competence allows the embodiment of at least one kind of ‘truth’ that is visible and replicable.

This can be a rare trait in an era of ‘fake news’ and shifting trends.

The ability to manifest difficult-to-reach skills or abilities, across contexts, fosters confidence. This is not always the case, as we see world-class athletes who are buried by self-doubt. But working toward mastering or even just becoming ‘ok’ at something still constitutes one of the more reliable pathways toward self-confidence. You learn that you can do something that you find meaningful. Better yet, that you can continually improve at this, despite challenges and setbacks. You surprise yourself at each small victory. ‘Perhaps I’m capable of more than I think I am, in general?’. This confidence comes from a few directions:

  1. Feeling grounded in your current abilities and skills
  2. Learning new abilities
  3. Realising that you have ‘the ability to learn new abilities’

Competence provides real-world evidence for yourself, and others, that cultivates true, self-secure confidence. At the very least in the area of a chosen craft and, hopefully, more widely than that. Finally, hard-to-earn skills/abilities, coupled with confidence are two ingredients that can lead to opportunities.

Competence is rare and valuable; confidence highlights this to others and anchors oneself.

On choosing a ‘craft’; what I’ve learned from medicine

As is the nature of this website, a lot of content is simply me trying to articulate my own thoughts from ‘fuzzy inklings’ to at least partially structured ideas. The points below about pursuing a craft come from my reflections on a current decision to pursue emergency medicine as a specialty.

Credit: Hoot504 (Wikipedia)

Be lead by inclinations, but allow chance

Since medical school, I had assumed I would go into general practice. I was an older student, the training was shorter, it seemed quite flexible, and the generalist aspect appealed to me. Emergency medicine always glimmered in the background, but I wrote it off as too anti-social and life-interrupting for an oldie like me. GP with occasional emergency medicine work was the plan.

So when it came to actually working in each of these jobs, I was disturbed to find that GP did not feel a natural fit. Working in EM has been the first time in medicine that I’ve thought ‘this feels right’.

As mentioned before, thinking about why we like what we like is a strange thing, and can veer off into the messy subject of whether we even have free will.

“…you are not consciously choosing what you want. You simply want it. You can’t explain why you want it, but you do. And so choosing to do what you want (or choosing one want over another) does not mean you have free will because your wants have been given to you not determined by you.”

Sam Harris, ‘Free Will’

Nonetheless (and pulling a handbrake turn away from this chasm), you like certain things more than others. If you are unsure where to go, as I am many times, these inclinations can provide an initial starting point for direction and trial. Better to move forward into a thing, and to find out it is not for you, than to simply wait and wonder. Knowing something is not for you does at least two things; 1) teach you more about what you don’t like and 2) ricochet you from one direction to another, which is likely more suitable.

This article not only refers to craft as career. It can be anything outside of work. Any kind of practice that brings a sense of direction, intrinsic motivation, meaning, and satisfaction in and of itself.

“If you feel only half interested, if you find yourself more excited by your leisure time, then most likely you have not chosen a field that engages you. Think about the subjects out there that stir your curiosity, bring you back to that feeling in childhood in which you wanted to learn. The trade you are mastering has to in some way stir your interest and make you excited about the future.”

Robert Greene

Enjoy the bread-and-butter

How many people do we think start the guitar based on the performances of their favourite, world-famous musicians? Probably loads. How many of these people quit within a year? Again, loads.

Notwithstanding the people who stop because it genuinely wasn’t for them (moving from low to high(er) resolution understanding of what it is to actually ‘play the guitar’), many will quit because the first time they picked up a plectrum they realised the gap between them and Metallica is actually a million miles wide.

One of my colleagues remarked ‘no matter what you do, don’t do it because of the rare diagnosis made, or TV-drama life-saving procedure in a speciality…you have to enjoy the bread and butter’.

I’ve definitely been that guitar guy (in everything but the guitar). So this is something that struck me. Emergency medicine is obviously the coolest sounding speciality, and gets a lot of airtime on TV, showing bad-ass physicians cracking open rib-cages and doing weird and wonderful (…often questionable) procedures.

I needed to make sure I could enjoy the ‘bread-and-butter’, the stuff that comes into the department 99% of the time, day after day, forever.

• Chest pain
• Shortness of breath
• Falls and head injuries
• Substance abuse
• …and so on

I can’t recall who said this, but I heard on a podcast somewhere a remark along the lines of ‘the primary thing that separates excellence between individuals is the willingness to endure, better to enjoy, the boredom and monotony that every single person experiences, for long periods of time, when working toward getting better at something’.

That’s worth repeating.

Everyone endures boredom or monotony. There is a maturity in understanding that it is impossible to enjoy something all the time. And actually, enjoyment is part of the process, but not the single reason to do something. It comes and goes, but there is a deeper sense of satisfaction and meaning that can materialise from practicing something well.

Don’t like monotony? Try working for ten years for this guy before you’re even allowed to attempt making the egg tempura

Learn about the ‘mini-games’

Most occupations/hobbies/crafts have a number of ‘mini-games’ or sub-skills that constitute the whole. There is a bridge of skill-sets to learn between where I am now and becoming a consultant in EM.

As the first speciality to see a patient, diagnostic skills are extremely valuable, and the ’emergency’ part of the name, as well as patient volume make efficiency an important skill too. Patients can present in extremis, and so having clinical systems and frameworks to rely on helps reduce cognitive burden and stress. There are plenty technical mini-games to learn; ultrasound, airway management, vascular access, cardioversion, nerve blocks, chest drains…the procedures go on. People skills, leadership and management become increasingly important as a career progresses, until you’re responsible for the safe running of a department. Teaching students and trainees is an integral part too, and new areas such as palliative care, pre-hospital medicine, and increased point-of-care testing present new areas to master.

Just some of the ‘mini-games’ involved in EM:
• Technical/procedural skills
• Diagnostic and clinical decision making
• Generalism: all medical specialities can present themselves
• Dark arts of interpreting ECGs, XR, CT, ABGs, blood tests etc
• Leadership and management in a very dynamically shifting environment
• Teaching and training
• Soft skills of communication and teamwork with team and patients

My point is that each craft will have it’s own ‘sub-crafts’ to master, and some will be more to your strengths than others. But as you’re awareness of a craft grows, so too do you discover more of these mini-games. When we start something, our understanding is very low-resolution, which cannot be helped. To me, a figure-skater practices…skating…a lot I guess? But I know that there is much more to it than that, and appreciating and honing the sub-crafts that constitute ‘figure-skating’ are what the daily practice is actually about.

You likely won’t know or appreciate these sub-crafts until you actually start doing the thing. Then you can start to see what is beneath the surface, and what first appeared as a single, homogenous activity atomises into a constellation of meaningful sub-crafts to pursue and hone.

Thanks a lot for reading this, and I’d love to hear your own experiences and thoughts on the ‘craftsmanship’ mindset (julian@strongermedicine.com).

Further suggested reading: