Sorta Random Sunday: Expanding Your Island of Knowledge Comes at a Cost

As I recently read Ego Is The Enemy by Ryan Holiday, I came across a great quote and idea. Paraphrasing here: As your island of knowledge grows, so does your shore of ignorance. This is an idea that I think most of us intuit in some way throughout our life. However, at least until now, it had never really entered the forefront of my mind to consider.

But the implications are extremely important.

What does this actually mean?

Basically, as our knowledge expands, so to does the amount of things related to our expanding knowledge that we actually don't know about.

Small island, short shore. Little knowledge, less to know and to not know.

Big island, long shore. Big knowledge, lots to know and lots we don't know.

Think about this is terms familiar to us. Remember when you finished medical school? We felt like we knew it all. That we were finally prepared to really start taking care of patients and shouldering that responsibility.

Oh how wrong we were! Or at least I was.

That first day, week, month, and even year of residency was a constant reminder of just how much I did not know. Why? Because my island of knowledge had grown. But so had the shore. I knew the basics of tons of disease pathology and management. But each disease process carried outshoots and intricacies of management that I finally recognized but did not fully understand.

Why is this important?

As our island of knowledge expands, so does our shore of ignorance.

Therefore we are left with really 2 options:

Stop learning (i.e. shrink our island of knowledge) or
Do something about the expanding shore of ignorance

Well, I am hoping more of us will agree that the first option is a non-starter. We are naturally curious as humans and especially as doctors and life long learning is often what drew us to this line of work.

Well then, what is the answer? If we want to keep learning, our shore of ignorance will keep expanding. The more we learn about what is in our shore, the more the island expands and new shore keeps showing up. It is a game we cannot win.

Therefore, the goal is not to win.

The goal is acceptance and understanding

We can never eliminate our shore of ignorance. In fact, if we are successful as learners, it will only ever keep getting bigger. But that cannot discourage us.

The way to handle our shore of ignorance isn't to avoid it in the first place or to chase not down futilely like Captain Ahab.

Instead, the way to handle it is simply to acknowledge it and be aware of it. Issues of all kinds arise when we simply do not acknowledge or are unaware that we have any gaps in knowledge at all. That is where ego comes in, we stop asking for help, stop learning at all, and fail. These can be interpersonal failings or professional failings. But the outcome is not good.

Remember, there are 4 kinds of knowledge:

We know what we know
We don't know what we don't know
We know what we don't know
We don't know what we know

The goal is to go from the first two phases of knowledge to the second two. And to do that we need to understand that there is no 5th form of knowledge where we know it all!

As you seek to expand your island and your shore, these posts can help:

What do you think? What does your island of knowledge look like? How about your shore of ignorance? Were you always aware of it? What issues did that cause? Let me know in the comments below!