VOICE: ALEX LICKERMAN
Founder and CEO of ImagineMD, Alex Lickerman, direct primary care physician at ImagineMD, spent the first 20 years of his career as a leader at one of the top academic medical centers in the world, the University of Chicago, where he ran primary care for seven years and taught generations of today’s leaders in medicine. There he enjoyed a reputation as “a doctor’s doctor,” caring for many physicians who are themselves today considered leaders in their fields. He is a master clinician, routinely diagnosing medical problems that leave other doctors puzzled.
A nationally recognized speaker on the topic of resilience, his book, The Undefeated Mind: On the Science of Constructing an Indestructible Self, details evidence-based steps one can take to increase resilience and formed the basis of the landmark Resilience Project, which he began while at the University of Chicago and exported to ImagineMD as the Undefeated Minds program. His second book, The Ten Worlds: The New Psychology of Happiness, details an entirely new psychological paradigm that explains how it's possible to achieve a kind of happiness that can't be destroyed by anything. Living by medicine’s most famous aphorism, “The secret of the care of the patient lies in caring for the patient,” he counts his tenacity in designing preventive care interventions, managing acute and chronic disease, and making the right diagnoses as his greatest strengths.
Dr. Lickerman lives in Chicago with his wife and son. He counts exercising, reading, writing, and lively conversation among his favorite pastimes.
Six months into my second year of medical school, the first woman I ever loved brought our year-and-a-half-long relationship to an end, causing me to fall immediately into a paralyzing depression. As a result, my ability to study declined dramatically--and as a result of that, six months later I failed Part I of the National Board Exam.
"It was a devastating blow, not just to my ego, but also to my potential future: if I couldn’t pass Part I, I wouldn’t be allowed to graduate from medical school. My dean told me I could retake the test, but the next opportunity to do so was at the end of my third year of medical school. This was--to put it mildly--problematic: at the start of the third year, students leave the classroom and begin caring for patients in the hospital, an activity renowned for swallowing entire days of time at one stretch and causing all personal dimensions of a student’s life to atrophy. I’d have little opportunity to study the material I was expected to learn on the wards, much less the basic science I was already supposed to have learned during my previous two years of classroom work.
I had no idea what to do. My thinking spiraled in useless circles as I hunted for a solution, my depression intensifying as none appeared, and soon I found myself crouching at the edge of despair.
After a few days of giving serious consideration to dropping out of medical school, instead I became determined not only to retake Part I of the Boards and pass it, but also to score above the mean, something I’d never been able to do on any test I’d ever taken in medical school. Further, I resolved that no matter how much time I’d need to devote to studying for the test, my performance in the third year wouldn’t suffer--rather, it would be stellar. I didn’t just want to survive this obstacle; I wanted to triumph over it. I didn’t just want to pass the test and learn the material; I wanted to transform the experience of failing into a genuine benefit, into something I could one day say with conviction I was glad had happened to me.
I had no real idea how this would--or even could--occur. Nevertheless, I took action: I studied every spare moment I had, sometimes staying up late into the night, sometimes arising several hours early in the morning. I studied at every meal. I stopped watching television, reading for pleasure, even socializing with friends. For the entire year, I remained disciplined, focused, and relentless.
Then, ironically, on the day of the test I almost missed the eight o’clock start time (which would have disqualified me from being allowed to take it) due to an accident on the expressway that slowed traffic to a crawl. Our eyes riveted on the clock, my mother and I cheered as my father sped through two red lights to get me to the test center on time.
The test was scheduled to last two days--twelve hours in total. I finished the first day with a sense that I’d performed well. But then came a crushing blow: the next morning, just before the start of the second day, we learned that test security had been compromised by thieves who’d managed to steal copies from a test center in Michigan and that officials were considering invalidating the test results for the entire country. As I glanced around at the horrified expressions in the room, I felt my will to complete the exam draining away. But rather than close my exam booklet and walk out as I felt the urge to do, instead I resolved to continue as I had all year, in willful ignorance of the odds stacked against me, fighting with all my might to overcome my impulse to give up.
My determination paid off. In the end, test officials decided not to invalidate the results, and I not only passed the exam but also met my goal of scoring above the mean. I went on to graduate medical school and landed a residency at the University of Iowa Hospitals and Clinics.
But the true victory didn’t come until years later, sometime after I’d begun working as a primary care physician at the University of Chicago, when a medical student came to see me one day distraught over having failed her third-year clinical rotation in internal medicine. Hoping to encourage her, I decided to divulge the story of my own failure. And as I told her what had happened and watched her expression shift from despondent to contemplative and then from contemplative to resolute, I felt my shame over having failed Part I of the National Boards finally evaporate. Only because I had failed, I realized, was I now in a position to offer someone else who’d failed in a similar way that most critical of psychological nutrients: hope. What’s more, in telling my story to someone else for the first time, I realized that having to relearn all the material presented in the first and second years of medical school had made me a better doctor. It had not only broadened my knowledge base but also sharpened my reasoning skills, leading to an ability, I now saw, to make diagnoses I wouldn’t have been able to make otherwise, as well as highlighted for me the importance of focusing not just on the diagnosis and treatment of disease, but also on the alleviation of the emotional suffering that disease often brings. I had indeed transformed the experience of failing the Boards into a benefit--twice."