Overcoming Main Character Syndrome In A Medical Setting

I have a confession. I suffer from main character syndrome. I know. It’s horrible. Please feel free to judge.

As a virtual provider working with children who have hearing loss, I sometimes feel like I’m on an island. Of course, I don’t mean this literally, though I wish that were the case. What I mean is by practicing without other professional team members present, I forget that I’m one small cog in the collaborative medical machine of a patient’s life.

I don’t mean that what I do is meaningless. It’s meaningful, but I am not the only piece on the therapeutic board. A few years into my professional practice, I realized I needed some serious humbling to better connect with other providers on the team and best support the families I serve.

This isn’t a comfortable realization. I’m sorry to say, I have not yet succeeded in eradicating my main character mentality. My journey is a lifelong work in progress, but I’ve found a few strategies that have helped me along the way.

The main strategy? Leave your ego at the door. The secondary? Seek to listen. The third? Strive to learn.

This is my personal experience, and yours may be entirely different. Take it from a recovering main character. The process isn’t always easy, but it starts with acknowledging you aren’t the most important person in the room; the patient is.

The Fall of 2007

My high school

“BAND, TEN HUT.”

Approximately 100 high school band students freeze as my voice echoes through the football stadium. The crowd behind me mostly ignores the marching band, rushing to buy their chilly-dripping hotdogs and greased-boiled peanuts, except for the dedicated band parents who couldn’t care less about the football team. Why should they? The team doesn’t exactly have a winning reputation…I digress.

These few, scattered parents came for the band. We’re ready. Well, I’m ready, at least. I pray that everyone remembers to start on their left foot to march- an unfortunate, repetitive issue of late.

“Drum Major, Laura Apgar, is your band ready?” A voice from the podium box reverberates through the speakers overhead. I recognized the voice - one of the school’s English teachers in my junior year of high school.

Easy answer. I turn 180 degrees, offer my salute, perhaps taking myself a bit too seriously, and turn another 180 degrees back towards the marching band as I remove my shako in a swift, circular motion. The crowd cheers. I smirk. That felt good. I raise my arms to conduct and breathe, listening through the incessant bleacher noise to find my internal metronome.

Tick. Tick. Tick. I land on it. Everything turns dark. My arms move - fluid, confident, and seemingly without my knowledge. The band begins to play.

As I conduct, the world around me disappears. I see the colors of the music and the eyes of a few key players - the drum captain, the brass captain, my sister, my future husband. The lighthouses in the dark. Their frames move by in timed succession, but the notes dance, and colors splash around me in the fog. I’m finally free in the mercy of the storm.

This is magic, if not chaotic. This is what makes my heart sing. Not the movement or music, but the color of each note. Each sound erupts forth, cutting through my heart in knives of magenta, saffron, and indigo, breathing fresh air into my lungs.

I stand in a room, an easel and canvas before me. The beautiful dyes on the palette ache for the brush in my hand. It’s a desperate, moving painting. I pick up the fine-tipped brush…

I’m brought back to reality by the sharp pang of chartreuse. No, that isn’t right, I think, easing out of the fog. The painting fades away. My head burns as light fills my eyes. It’s supposed to be amber, not chartreuse. Like a sleeping bear woken too early, I squint my eyes to see past the blinding stadium lights and find the culprit: an overconfident trumpet player.

At least he’s marching in step. I think sarcastically. I squint harder. …or not. I glare at him. He sees me, and I watch him sheepishly pull out his tuning valve. The amber color returns. Good.

At that moment, I’m reminded of a harsh reality. No matter how obsessive, dedicated, or even, dare I say it, nerdy I am, my abilities are nothing if the colors don’t blend. If the lighthouses aren’t lit, if the storm isn’t harnessed. I’m confronted by my lack of control. I’m not free.

My freedom is an illusion. Freedom in a storm is a boat lost at sea. A paintbrush is nothing without the colors it is a vehicle for.

To allow individual arrogance to take the place of humility and a desire to learn is accepting defeat. The assumption that one person’s opinion is more valuable than others on a collaborative team is a serious concern and unethical if taken to extremes.

There are exceptions where one person’s opinion on a team makes all the difference in a final decision. Can one person change the entire outcome for the better? The answer to this is yes and no, and therein lies the paradox that many teams face. It’s also why main character syndrome is rampant in medicine. The field attracts gifted individuals, who are used to being both the leader and wisest in a room.

This is a blessing and curse. In a medical setting, egos and overconfidence in pedigree can incite more harm than good. In an effort to maximize productivity, for example, medical providers may be dismissive about the life-altering information they are relaying to others, because, What’s the big deal? It isn’t like they are dying. What is the point of having a social worker present anyways?

The problem is, for most families, this information is a huge deal. For example, in the case of a profound, bilateral, sensorineural hearing loss diagnosis of a child. While the diagnosis may be another day in the office for the clinician, the family’s new reality can act as a sort of death for the life they expected their child to have. While the doctor may have the knowledge to relay such information, and certainly should, tapping into other services on the team acknowledges other skills needed to create greater support for the family.

Each individual on a medical team offers a plethora of knowledge regardless of perceived academic skill level. Each bit of knowledge provides a bridge for new learning, presenting opportunities to lean into humility.

Humility nudges providers to be present, lest they miss opportunities for growth. Growth requires listening to all perspectives, without the assumption of knowing best. Genuine, self-effacing listening encourages expanding beyond perceived potential to skills with more depth and nuance.

This process is a version of the quote, “The more you know, the more you realize you don't know.” Attributed to Aristotle, Einstein, and others. Lessons of humility aren’t always comfortable, but they should always be sought, regardless of self-identified skill level.

It’s the speech pathologist who confirms with the audiologist that the client can actually hear the sounds they are working on.

It’s the surgeon who takes the time to listen to the social worker regarding concerns that the family is unable to understand the language and medical jargon used during appointments.

It’s the school team who listens to the suggestions of the LSLS Certified Specialist on the topic of hearing loss, and the LSLS Certified Specialist who makes time to visit the school and to prioritize the team’s concerns.

It’s the medical team that understands who the main character really is - the patient.

It’s the humble and the present, who bring out the best in a team. It is the individual who, instead of viewing their co-workers and teammates as blindspots, shifts the mindset to seeing others as a mirror of themselves.

Keep main character syndrome at bay by listening, learning, and keeping the ego at the door. It’s time to shift the mindset to becoming a side character in the main character’s story.

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