When faced with a particularly difficult decision, Alastair Mitchell Mitchell uses the “big red bus test.” He thinks about walking out of his building in London and crossing the street, only to turn and see that one of those monstrous London double-decker red buses is literally about to flatten him and send him to the hereafter. In the brief instant before the bus hits him, he wonders what would be the thing that he would most regret not having accomplished. The answer to this question should guide prioritization of the efforts of a successful chief executive officer, businessman, or (presumably) ophthalmologist.
By Peter J. McDonnell, MD
Alastair Mitchell is the youthful chief executive of a software company called Huddle. Mitchell’s leadership acumen has made him the subject of articles in The New York Times and other business periodicals.
Noted for his success as an entrepreneur, Mitchell offers the following wisdom to college students just starting out:
“I’d say go big or go home. And just trust yourself. Whatever your gut instinct is, you'll probably be right seven or eight times out of 10. So just go with your gut. We're here for only a very short time, so why not try to build something great?”
That makes some sense to me. But I wonder if everyone’s gut instincts are really trustworthy. If possible, relying on good data and employing objective and verifiable solutions (e.g., evidence-based medicine) strike me as advantageous.
When faced with a particularly difficult decision, Mitchell uses the “big red bus test.” He thinks about walking out of his building in London and crossing the street, only to turn and see that one of those monstrous London double-decker red buses is literally about to flatten him and send him to the hereafter. In the brief instant before the bus hits him, he wonders what would be the thing that he would most regret not having accomplished.
"What is that burning thing inside of you that often eats at people at night?" The answer to this question should guide prioritization of the efforts of a successful chief executive officer, businessman, or (presumably) ophthalmologist.
What, I wondered, would I end up wishing I had achieved in the instant before the large red bus splatters my brains and body parts onto the asphalt? It wouldn't be that I'd regret not pursuing a different career, as ophthalmologists really do help people and that is extremely rewarding.
Also, the pay may not be up there with neurosurgeons, but it is more than satisfactory, so I don’t think my dying wish would be to have made more money.
My children are doing well.
The organization for which I work is admired around the world and I am happy to be in a position to try to contribute to its continued success.
About the only thing that occurred to me offhand is that I have never seen Florence, Italy, and since taking my art history class in college I have known that the works of art located in that city demand a visit.
"Does my not having a burning uncompleted task pop right into my head mean that I am not ambitious enough?" I wondered. What would successful professionals I know come up with as their answers?
So I applied the big red bus test to two extremely successful physician friends of mine. Although only one is an ophthalmologist, both are loyal Ophthalmology Times readers, undeniably a sign of profound intelligence and sophistication. In succession, but individually, I verbally painted for my two subjects the instant at which they realize that the huge magenta mass of metal is hurtling down on their all-too-frail human flesh.
"So what thought leaps into your mind?" I asked subject number one, eagerly awaiting his response.
"Nothing," he replied, "because there is no time for thinking in the brief instant during which my cat-like reflexes cause me to leap back onto the sidewalk, allowing me to live a long life and accomplish many things."
"Thanks for nothing," I responded.
While subject number one is clearly in denial about his mortality, I knew my second subject to be a very thoughtful person who would not refuse to face the reality of death. Her response, I felt certain, would make my wanting to visit Florence pale in significance.
I told her about Mitchell and asked what she would most regret not accomplishing.
"Looking both ways," she replied.
I wonder how you, dear Ophthalmology Times reader, will answer.