As I have moved further into my career as a physician, I have asked myself a question over and over: what drives people? What is the essence of motivation? While the answer can be made simple and obvious (pleasure, gratification, happiness, reward), motivation is something many of us take for granted on a seemingly-unconscious level: human beings often do not know how or why we seek out certain activities—we just do.

I ask this question to understand myself more than anything. What drives me? Why am I interested in everything from classical music to cumulative doses of x-ray radiation causing increased risk of cancer to open source web browser development to current events to computer nerdery to cycling to ACGME guidelines on the resident 80-hour work week limit to giving forceful, impactful, meaningful presentations to photography? The list goes on and on. These things are pleasureful to me, not necessarily to others. Where I derive satisfaction from parsing my iTunes XML library file, syncing it into a SQL database and analyzing its contents, others probably would not find this fun in the least. (Shima, I’m thinking of you.) This question is deep and is very difficult to answer, yet in the past couple months, I have been asked about this many times: What drives me? What motivates me? Why have I succeeded where others have failed? I will try to answer this here.

Rands In Repose put it best by breaking down why gamers are fixated by the games they play:

We see the world as a very complex but knowable flowchart where there are a finite number of inputs, which cause a similarly finite set of outputs. This impossible flowchart gives us a comfortable illusion of control and an understanding of a chaotic word, but its existence is a handy side effect of a life staring at, deducing, and building systems. It’s also why we love games — they’re just dolled up systems — and the more you understand this fascination with games, the better you’ll be at managing us.

As with all mental excursions with geeks, there’s a well-defined process by which we consume a game, and it goes like this:

• Discovery
• Optimization, Repetition, and Win
• Achievement

This really struck a chord with me and brought me back to all my urology residency interviews I have been on during the last few months: how and why do I participate in so many other non-medical activities and how have I been able to not only dabble in some of these but master them as well? I’m not trying to toot my own horn here, but I’ll tell you my secret. Number one: I have many interests (alluded to above). They vary widely because that variety, for me, is satisfying in and of itself. I can relate to people on many levels and each offers something unique that is not provided elsewhere. In other words, I am stimulated mentally in various ways, not just one. Number two: It is the creative versus the logical. I pursue many activities in different realms so that I can enrich and broaden my knowledge in the hopes that discovery in one area might lead to an innovation in another. This approach necessitates broad interests and has created a positive feedback loop, whereby more interests spur more discovery as my appreciation and depth of knowledge grows.

Take my work for example. As a surgical intern, I have to gather vitals, labs, radiology test results, and more each morning for my patients. This is somewhat time consuming and mindless—save the interpretation! My intern peers do exactly the same thing for their umpteen patients every morning, every day of the week. Rather than simply act as a mindless transcriptionist using the same dumb tools day after day, I stepped back and _thought_ about how I could improve this. The data is all in the computer, I have a computerized list of my patients. Why couldn’t I develop a new tool to bring this data to me automatically formatted each morning. So I did just that, using my computer savvy to create a report of such information. It was fun and I learned new things at the same time. Pushing the envelope is satisfying and I was able to use knowledge from one interest to solve a problem in another. Simple, straight-forward, awesome.

Anyone can sit at a job and do that job day after day using the same tools. Few seem to delve deeper and ask, “Can this be done more efficiently?” This is innovation. It is fun, it is motivating, it is challenging, and I love it. Original thinking requires thought, poise, gumption, and conscious effort. I’m not just talking about computers, though. Improvement can involve people, organizations, tools, timing, the political process, and more. Too often, I see anonymous people going about their day in mindless manners, simply doing because that’s what they’ve always known and done and have no reason to change it. This passivity appears more and more pervasive in individuals in many aspects of life: political discussion, technological know-how, creative aspiration and expression, scientific knowledge and understanding. I have even seen people spurn others for involvement in such activities.

“You bake?!”

“You write computer programs?!”

“You read about economic policy?!”

“You speak French?!”

Anything outside their comfort zone is disquieting and jarring. I reject this wholeheartedly. Life is not meant to be consumed in neatly-organized cubes that fit squarely next to one another. Life should challenge, encourage inventive thought and discussion, should wake people up and consciously express desires and actions to push society forward. This drives me. And while I have goals, I relish the means to attaining those goals, not simply satisfied to reach them. This is why I would never, ever choose to simply zip forward to the future to see where I end up: I would never know all the bumps and bruises and petabytes of knowledge my brain churned through to get there. That is where we grow. This is where wisdom is born. I aspire to this model, and I encourage others to follow it as well.

My interest in this area and my thoughts on the matter were the inciting agents for refreshing this space, motivating me to change its inherent direction and content. While blogs originated as a medium that is highly self-serving (witness the many narcissistic entries in the archives that pertain solely to this space), they have morphed into something more. The blogs I read aren’t so much blogs as means to discovering new, fun, interesting information. Technical, medical, humorous, insightful. These are descriptors of things I want to learn from and discover. My significant other (Shima!!!) asked me recently where I find all the tantalizing links I send her. I search, I read, I pour over blogs of people I respect. I do it every day like clockwork. I like being up on current events across all the sections of the classic newspaper (local, national, international, business, politics, technology, etc). These are my goals for this space, eschewing the self-deluding nature of the “look-what-I’ve-done” post so common before this one for posts that convey useful, inciting nuggets that can inspire others. I want to share what drives me here with you in the hopes of energizing your inner drive.