Envy Is The Last Refuge of The Impotent

Year 3 of residency is within the study's field of view. The scars of internship have mostly settled into their permanent shape while the recall of meaningful and precious experiences is triggered at a steady rate. The delightfully improbable friendships have prevailed against tests of time and distance.

Many things are significantly changed— around me and about me. Transplanting one’s life 1600 miles to a different climate and time zone has the neat side effect of eliminating confounders in the analysis of one’s personality— circumstances create trends, what exists across them are the traits that endure. In this current iteration, I try to master the enduring irritation to a stimulus we may be becoming exceedingly tolerant of.

In many cultures, Children are promptly and often publicly chastised for displaying, and worse acting on, feelings of envy of their peers. Grades, gifts, attention, awards…the list of available inputs to that base function is long and unmasks the infantile materialism of children in that it assumes an objective system for quantifying the value of a life actually exists. The social disgust we feel over envious people is an effective deterrent that shapes the growing mind toward repression and avoidance of envy. By adolescence, it’s  but a distant memory. You enter college, realize that you greatly underestimated the size of the pond in which you will be competing, master your identity crisis while discovering your unique strengths. Your ego recovers from the initial shell shock because you find those problems that you’re uniquely suited to solve. You make friends and build rapport. Having real responsibilities reshapes the mind: you want to be good to do good. And your peace is knowing you can be successful. 

So in my third year, I ask myself: how the fuck did we get here?

Residency is the culmination of 100 billion individual and arguably privileged choices, yet, somewhere on the long and tortuous path, the economics of envy changed: it’s your party, and you’ll cry if you want to. The function hasn’t changed, but the inputs now extend to intangibles: a joke you don’t get, a language you don’t speak, an experience you have not had, a curiosity you lack. Material triggers are somewhat muted by the necessary uniformity that governs the hospital but they still exist, and when summoned at after-work functions, they report for duty as sharp and eager as ever. Duh.

You don’t throw fits. You throw people— under buses. Someone answered a question whose answer evaded you; you don’t cry— you use flattery to distract the one who asked it to begin with to reduce the opportunity for the other person to receive praise. A quick compliment to your attending, what’s the harm. After all, you paid for that sh*t with countless hours of careful observation during dinners and off-duty chatter that must have been pretty mind-numbing— even for you. A newbie comes in with a confidence you don’t like. You would never tell your peers that the only relief for the tension that’s been building since the new guy arrived, since you began picturing a future where your influence looms slightly less large, is for the group to shun them forever; better to mythologize that confidence as arrogant aggressive behavior. Better still, refractory arrogant aggressive behavior that persisted despite your generous private (read fictitious) coaching of the outsider. Alas, you’re not wasteful and extract with cruel precision as much as you can from the junior trainee: you use your insider knowledge of the comings and goings to carefully time empty offers to explain something with the usual arrival time of the attending; they are busy people after all— hearing you talk about nurturing others registers the same as if they had seen you actually do it. You decree your successes and carefully staged crises in public; you compliment the new guy in private only— nothing to see here, honi soit qui mal y pense, motherfuckers.

Of course, there is blame to be had by the average and above average spectators alike. Both may have indulged in the brief ego boost that costs the envious overlord nothing but feels so good on a day when our profession and training are…let’s say extra humbling. Other allowances may have been made in times of need with hopes for leniency or participation in a really cool case that would further their education and experience in a meaningful way. Last but not least, the blame also falls on those who accept the opportunity cost, who value truth and transparency over feathers that may not so easily be un-ruffled but chose ineffective approaches that do not yield change-- or worse, curtail their influence instead and driving them into eventual indifference. 

When inaction is the default and action may have unintended consequences, we need to revisit our assumptions on, and treatment of, the offending agent: let us agree that envy is the last refuge of the impotent. To give into envy is to fully accept that one’s limitations exceed one’s aspirations. As long as egos exist in this world, I cannot think of a more potent deterrent.