As a doctor working in Canada, I know that I am very lucky and should be eternally grateful. In a world that talks about fake news, this is not only objective truth, but something of a daily mantra. I am overpaid for a job I begrudgingly love, and did nothing to deserve good genes. Nevertheless, I am chased—though not sufficiently chastened—by nagging questions. While this medical job has fine-tuned my smarts, what has it done to my soul? And, despite winning Willy Wonka’s golden ticket, why is it so easy to be so self-centered?

If I were to add another question, it would be “and when did I change?” After all, I was that medical school interviewee who meant it when I answered that I simply wanted to help others. I was that teenager who could not walk past a homeless person. I would stop, talk, and happily leave a few coins. Now, when somebody asks for money I hesitate and worry that I am sponsoring their next high. When solicited on my doorstep by various charities, I tend to polemicize that, as a doctor, “I gave at the office.” For much of the last decade, I have had my selfish head in the clouds and my disdainful nose in the air; usually rushing to a meeting that doesn’t matter, or to procure a trinket I do not need. Is it just me? I didn’t think so.

We should all prepare for that moment, where we face the cold hard truths about what we have become. It used to be called a mid-life crisis, but I’m probably too old to use that excuse. Regardless, mine came when I couldn’t sleep on a business trip to Asia. I had nothing to read, so resorted to the Book of Buddha in my hotel bedside drawer. I subsequently spent a fitful night of uneasy self-reflection. Upon my departure, I, uhm, stole the book from the hotel. Stealing is dead wrong, I am deeply ashamed, and it helps to admit this. Moreover, it showed just how much I had lost the plot. I was stuck in the narrative that my needs mattered most, and he who dies with the most stuff wins. To paraphrase my bedside guru: be careful what you wish for, it may come true.

The best-selling author, David Brooks had his own crisis of faith. In his book, The Road to Character, he laments how we spend excessive time cultivating the so-called “résumé virtues”: impressive accomplishments that wow others, and feather our beds. In contrast, we spend precious little time on “eulogy virtues”: those that make us worth love rather than respect, and determine whether our funeral will need the space of Wembley Stadium or a telephone booth. Brooks spent his days with the so-called “good” and the “great”, but rarely met the “content” or “generous.” He concluded that too many people were living lives of success and celebration rather than significance and service.

Others have warned of a narcissism epidemic. In my case, and in my day, this happened despite several traditional safety valves. Namely, I had parents who made it clear I was nothing special, and a woeful bank balance until relatively recently. As such I am especially fearful for those growing up today. Narcissism refers to selfishness, a grandiose view of one’s own talents and abilities, an entitled belief about one’s own needs, and a craving for admiration and attention. Let’s be honest, our otherwise laudable profession attracts and then selectively breeds these traits.

So, what of the original Narcissus? Greek legend tells of a man who stared into a pool, saw his own reflection and fell irrevocably in love. Unable to look elsewhere he ultimately led a meaningless life. The danger is that even when we do donate our time or money it is usually to magnify our image, or broadcast our virtue. Outside of work we may only give when it indirectly benefits us (“well, my kids attend that school”) or when we have a personal connection (“my sister had multiple sclerosis”). Not everything should be done with hopes of something in return. Going forward I want to divide my life into not only learning and earning but also returning. I am trying to put others before the mighty me. I will fail more than I succeed and for once that is okay. Regardless, I feel lucky and grateful that it is not too late to craft a better, albeit slightly more modest, me.  

Peter Brindley, professor in the department of critical care medicine, Department of Anesthesiology and Pain Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada. He is on Twitter @docpgb

Competing interests: None declared.