Perfection

I have a patient: "M" She suffers greatly from perfection. Most fittingly, she sees me for essential tremor. It is a "benign" condition, but I'm not sure why it's called that. Her employment as a sort of artist requires incredible fine motor skill. Especially her surgeries. She is a graduate of the finest schools in the nation where she achieved the highest grades and greatest honors. She is the best. Her career has used her seven days per week and most of her waking hours. Her business has flourished. She has great prestige in the community. Now, her stress is making her tremor far worse.

Medications for essential tremor are challenging. They help, but don't eliminate the tremors. They tend to have significant side effects. At times, the side effects are worse than the illness. The surgery for tremors is reserved for medication failures and disabling tremor. It is somewhat dangerous. Brain surgery tends to scare people somewhat as well.

Perfection is difficult. I think it comes for a sort of "emptiness". It is a cry for acceptance. It is a cry for someone to say "You are wonderful. You are the best." The perfectionist doesn't seem to think that they are "good enough". So there is an emptiness of "good-enoughness". "Good-enoughness" can't be achieved from actions of skill, prestige, hard work or admiration. It can't really come from another's love - neither erotic or platonic. It is internal: an internal knowing, satisfaction or fullness. Perhaps it is an inner peace of sorts.

I see "NGESI": "Not Good Enough Soul Injury". People get injuries to the body, mind and soul. Perfection is a response to this injury to the soul. It is an injury that may come from childhood, I suppose. If one has perfection they think that this will cause them to know that they are good enough. There is "proof" from going to this school, from this degree, from making this much money, from having this fancy car or house or something. But the proof doesn't penetrate our soul: it is only inside a brain. There are brain-soul connections. But not all that is in the brain goes to the soul. So perfection can't cure the injury. Perfection is "a place" where one hides from the suffering that feeling the injury brings. It is a distraction from Truth.

The Truth is, there is injury and suffering. I don't know of a cure. Perhaps someone else does. I think that there is suffering. Knowing that this is a suffering and recognizing the injury is unpleasant and painful and difficult. Often, I think, the harder the path the more beneficial it is. We can know that this pain is here. And we can say "Hello my NGESI." We can welcome the NGESI for a visit. It comes and goes. It isn't a friend. It is a visitor. Perhaps it is an enemy. Perhaps it isn't. It may be an unpleasant teacher. Many teachers are unpleasant, even bordering on abusive. I don't know what NGESI is. But if we sit with it, we become familiar. Familiar is also comfortable. This could decrease the pain. We don't hurt so much when we're comfortable. In fact, in a way, "Pain" is just a variation of "not comfortable". It's all about the linguistics.

But to cure someone I would need to find a way to have them "let go" of perfectionism. This, I don't have a pill for. And what's more I really don't know how I sign up someone for that. People don't like letting go of things, they like getting more things. I'm not supposed to encourage people to suffer: I'm a physician. What I'm supposed to do is decrease their suffering. Either that, or fix the tremor. If I could fix the tremor, then I could return "M" to her state of perfection. That is what she came to me for, after all. "Success" as a physician is making sure you listen to what the patient wants (usually, but not always, a cure) and providing that.

And I can't fix her tremor.