At this time of year, along with the majority of medics, my thoughts are turning a lot to the process of reflecting on clinical practice. This is something that I think most of us do most of the time, but written reflections form a mandatory part of continuing professional development for most medics. Many of us fail to keep on top of them, and end up with a glut to write towards the end of the financial year.

I’m also currently reading Haruki Murakami’s Novelist as a Vocation. I’ll tell you more about that when I’ve finished it, but I wanted to feature this passage (actually, two concatenated passages) where Murakami is giving advice to aspiring novelists on reflecting on their everyday experiences. It’s as good a description as I’ve read anywhere of the process of reflection, and so really resonated with me.

Make a habit of looking at things and events in more detail. Observe what is going on around you and the people you encounter as closely and as deeply as you can. Reflect on what you see. Remember, though, that to reflect is not to rush to determine the rights and wrongs or merits and demerits of what and whom you are observing. Try to consciously refrain from value judgements—conclusions can come later.

I strive to maintain as complete an image as possible of the scene I have observed, the person I have met, the experience I have undergone, regarding it as a singular ‘sample,’ a kind of test case, as it were. I can go back and look at it again later, when my feelings have settled down and there is less urgency, this time inspecting it from a variety of angles. Finally, if and when it seems called for, I can draw my own conclusions.

I really liked this description, but it was Murakami’s next paragraph that completely stopped me in my tracks:

Nevertheless, based on my own experience, I have found that the occasions when conclusions must be drawn are far less numerous than we tend to assume. Indeed, the times when judgements are truly necessary—whether in the short or the long run—are few and far between. That’s the way I feel, anyway. This means that when I read the paper or watch the news on TV, I have a hard time swallowing the reporters’ rush to give opinions on anything and everything. ‘Come on, guys,’ I feel like saying, ‘what’s the big hurry?’

When Wendy and I are watching the news on TV, we frequently comment “It’s not though, is it?’ in response to opinions given by reporters who get caught up in their story’s importance. It irritates us when reporters give commentaries that a moment’s thought would dismiss: ‘this is the most serious crime of the decade,’ ‘this is the biggest political crisis since the second world war,’ ‘this is a make-or-break moment for the political party,’ and that kind of thing.

I’d never before made the connection between thinking reflectively and avoiding a rush to judgement. Now that it has been pointed out, it’s obvious—but reading the above passage was a definite ‘aha’ moment for me, a moment that allowed to see a connection between disparate ideas for the first time.

The picture at the top of this post is an AI-generated image for the prompt ‘a photo of a doctor looking pensive in a mirror’ created by OpenAI’s DALL-E 2. The mirror is a pun on the word ‘reflection,’ just in case that’s not immediately obvious. There’s nothing funnier than a joke that has to be explained.