The Many Slips Between Cup and Lip (Radiological and Otherwise)

My driveway is almost back. It went away for the winter.

When the driveway freezes, a lot of vehicles can’t quite manage its long slope. We’re also right by the water and onshore winds have a way of instantly turning a bit of rain or snow into a sheet of shovel-defying ice. I had been wowed by the notion of a heated driveway many years ago and decided that I would have one before 2025 hit.

The well-reviewed guy I picked for the job was pretty firm about how late in autumn the job could begin. One needs certain intervals of reliably dry and non-frigid temperatures so the electrical works and new paving can be put down. We got started in time and, courtesy of a “La Nina” year, we were expecting the oncoming season to be favorable. Demolition of the old driveway promptly occurred on schedule.

Suddenly, temperatures plummeted well below average, accompanied by plenty of extra precipitation. Everything ground to a halt, and we were left with a sometimes drivable dirt/gravel path for the next three months. Now that winter is over, the heating pads were just put down. If fate is kind, we might have asphalt applied in the next week or two. When winter returns (in eight to nine months), I can look forward to finally seeing the thing do its melty job.

Some might wonder if my head is screwed on correctly when I say this is a pretty good outcome. Others, especially folks who know the background of other projects I have undertaken around my home during the past decade, can more easily see where I am coming from.

There are a variety of pitfalls that could have occurred at earlier stages of this endeavor but didn’t. One or more guys doing work on the driveway might have flaked out, showing spotty attendance, or disappearing entirely. The manufacturer of the heating pads (based in Minnesota) might have screwed up the order, sending wrong or defective items, or being indefinitely out of stock. The HOA or some regulatory entity might have come by and found fault with what I was trying to do.

I can keep on listing potential misfortunes, and there are unquestionably others that I wouldn’t think of until they happened, after which I might ruefully nod and say, “Yeah, I could have predicted this.” Then there are “black swan events” which nobody would have guessed but come out of the blue to derail everything.

Circling back to the driveway, it is not completed yet, but to get this far with everything working out except for the weather, I consider it batting well above .500. Wind the clock back about 10 years, and I would be singing a different tune. I took it decidedly less gracefully when it required multiple rounds of roofers to fix leaks and HVAC people to keep my house from freezing in the winter or steaming in the summer. I have either wised or softened up.

It is a lot harder to roll with the punches when the stakes are higher and that includes stakes you have already paid. Radiology, or for that matter any aspect of health care, is a good example. In addition to lives literally being on the line, there is a lot of moolah moving back and forth, and for those of us who chose to enter this field as a career, we have invested a lot of time and trouble to get (and stay) here.

All of this generates a gut feeling that things should work, and they should work well, especially for things we have carefully planned out. When they don’t, it’s understandable for us to react badly with anger, despair, or jadedness.

It’s like an inverse of Gell-Mann amnesia (see my blog from last August). In any other walk of life, when we see things fail because of unreliable or incapable people, faulty equipment, or plain old bad luck, we might accept or even expect it. “Rule one: People are stupid,” as a GI guy in my internship hospital used to say. But in our professional bailiwick, we somehow still expect better.

For example, I have mentioned in past blogs that my last on-site job supposedly included a path to partnership. Local scuttlebutt was that the managing partner was a weasel and would find some way not to honor the commitment, but all other groups in the area were even worse, so I decided to go for it. At the very least, I reasoned, if I made myself indispensable during the four years of the track (times were different then), in spite of himself, he would have to retain me somehow.

The years went by, and I daresay I was crucial to the group’s growth during that time. The managing partner himself called me a “pillar of the practice.” When the time came, however, he dragged his feet and ultimately failed to offer anything resembling real partnership. Having anticipated this, I essentially asked him how much more compensation he would give in lieu of equity and he came up with absolutely nothing.

From his reputation and my lesser degree of life experience at the time, I saw only one explanation: He was a welcher/liar/cheapskate, who was unable to see the bigger picture of how keeping me around would be to his own benefit in addition to an honorable thing. That could still be precisely accurate.

However, having subsequently seen how many things, predictable and otherwise, can interfere with man’s best-laid plans, I can now picture a bunch of other possibilities. Perhaps the changing landscape of health care (or radiology in particular) turned his viable “we could take on a partner” world changed into one of “we are slowly going under.” He might have reasoned that, if he opened the books, I would take one look and head for the hills.

Freshly through those years, it would have been easy to regard them as wasted time, a valuable chunk of my youthful career. Looking at it in the same way as I do my almost finished driveway, I now see it as a time in which I gained valuable experience and confidence, earned a competitive living (at least, in my geographical area, the salary during the partnership track years was good), and maybe a couple of life lessons.

The only thing that went “wrong” was that I didn’t get the partnership feather in my cap. Knowing how that practice turned out in the long run, I probably came out ahead.