Look Down A Trachea And Succeed With A Growth Mindset

In the ICU, we had to perform a bronchoscopy on a patient to rule out excessive bleeding in the lung. It might have been my attending who was in a good mood or the fact that I was just sitting at the computer responding to WordPress comments, but whatever it was, he asked me to do the bronchoscopy. For those of you who don’t know, a bronchoscopy is a procedure where you take this thin tube with a camera at the end of it to visualize the inside of someone’s airways. The procedure looks like this. Gross, I know. I’m not much of a procedure person, but as I was standing there holding the scope in my hand and looking down this guy’s trachea, I came to a realization. Bronchoscopy is a type of endoscopy, and endoscopy means to look inside.


Bronchoscopy (Courtesy of WebMD)

Do you ever feel like your life is controlled by things outside of your control? Your boss needs you to stop your project and fix his computer. Your significant other needs you to drop what you’re doing and fix the plumbing. Even your alarm clock yells at you to stop sleeping and get out of that warm and comfy bed. How much control do you really have?

A person’s “locus of control” was described by Julian Rotter in 1966 as the how much control individuals have on their lives, whether it be internal factors or external conditions. For example, take two students who received the exact same bad grade on a test. Let’s say they got a D+. The student with a strong external locus would believe that their bad grade was due to the test being hard or the teacher not teaching the material. The student with the strong internal locus would blame themselves for not studying enough.

Which would you rather be? Well, before you answer that, let’s take those same two students but this time they got an A+ on that test. The external locus student would say that the test was too easy or that the teacher was great. The internal locus student would praise themselves for studying hard.

In both scenarios, the external locus student believed that their grades were due to their teacher or test difficulty, whereas the internal locus student believed their grade was due to their own ability. However, if both students took another test, studies have shown that the internal locus student would do better.


Snorkeling in the West Indies. I’d definitely fail the Navy SEAL Basic Underwater Demolition training.

By shifting your locus of control internally, I think we can perform more optimally and be more successful. In this study (Paulus M, Potterat E, Taylor M, et al), researchers looked at which Navy SEALs performed better under extreme conditions such as performing complicated tasks underwater. They found that optimal performers had a strong internal body state as compared to suboptimal performers. That is, people with a strong internal locus performed better. So why does having a strong internal locus correlate with optimal performance?

People with a strong internal locus tend to have a growth mindset. Carol S. Dweck describes a growth mindset in her book, Mindset: The New Psychology of Successas the perspective that one can acquire new abilities as long as one puts in the effort and work. This is in contrast to fixed mindset, where these people believe that characteristics such as intelligence, athleticism, and creativity are fixed traits. By having a growth mindset, the potential for someone is boundless. They can study to be more intelligent, train to be more athletic, and even learn to be more creative.

So as I finished up clearing out my patient’s alveoli, I felt grateful for being able to do such an amazing procedure. Being able to look inside someone else to essentially save their life is a marvel in today’s medicine. But instead of looking inside others, we should look inside ourselves. By looking inside we realize that we control our decisions, our fate, and our lives. That realization is empowering, and I can only imagine how much we can accomplish with that mindset.

Key Points:

  • Locus of control refers to how much control one has over their life.
  • Internal locus of control correlates with higher performance, as seen in the Navy Seal study.
  • People with a growth mindset believe that their most basic abilities can be developed through dedication and hard work – brains and talent are just the starting point.


Add the word “yet” to your vocabulary. Carol Dweck talked about the power of yet here. The way it works is like this. Every time you find yourself saying that you can’t do something, add the word yet to that sentence. For example, “I can’t draw” becomes “I can’t draw, yet.” So everything you can’t do becomes everything you can’t do, yet.


Leave a comment below! It’s not that you won’t leave a comment, it’s that you won’t leave a comment, yet.


27 thoughts on “Look Down A Trachea And Succeed With A Growth Mindset

  1. sparkyjen says:

    Yo Doctor Mike…loving the blog. I’m huge on research. No, I didn’t follow the link to see the procedure. All I read was the word yucky or some such, and that was enough for me.

    Wow! The Power of Yet. I’m going to read up on that. I must tell you it would make an excellent blog post all by itself.

    Great Scott…if you’re as good a doc as you are a blogger, then there some blessed patients out there already! Of if not yet…there will be.

    Liked by 1 person

  2. daveply says:

    “Brains and talent are just the starting point.” I agree, but I’d also assert that they’re the ending point too. No matter how much work someone puts in, they will not become an elite artist, athlete, or intellectual if they don’t have an innate talent for it. “Boundless” overstates reality, and by a large margin. That sort of hyped up rhetoric does no one any favors.

    But I’d also agree that people can acquire new skills and improve existing ones if they’re willing to put in the work, even in areas where they have limited talent. They may just be limited in how far they can go with it.

    Liked by 1 person

    • doctormikesblog says:

      You bring up a good point on my overstatement on “boundless.” I get excited sometimes with these kinds of statements, and it shows in my writing. However, I would have to disagree with you on your perspective on how far someone can go with their innate talent. I still believe that we can keep on acquiring new heights and achievements as long as we put in the work. Some may need more work than others, that’s for sure. And there is definitely a discrepancy on how we measure people’s abilities as well. For example, someone might be perceived as an excellent artist on such and such scale, but may be poor on someone else’s scale. Of course, if we don’t have a standardized type of measurement, what’s the point? Well I digress. I enjoy your rhetoric and thanks for the comment!

      Liked by 1 person

      • daveply says:

        While it’s true that artistry is too subjective for good metrics, there are plenty of other things that are more measurable. How many athletes, despite trying their absolute best and putting in endless hours never make it to the pros? How many of your follow medical students washed out despite their best efforts? They couldn’t have all been slackers.

        Liked by 1 person

      • doctormikesblog says:

        Such smart questions! You bring up really good points which I do agree on. You’re right in saying that boundless and unattainable results aren’t attainable for some people, especially when your final decisive factor is whether they became a professional athlete or finished medical school and became a doctor or whatnot.

        However, I think in order to become that professional athlete or medical doctor, we need SMART goals. I’m sure you’ve heard of it, but SMART is an acronym standing for Specific, Measurable, Attainable, Realistic, and Timing. I’ll use the goal of playing in the NBA for a high school basketball player as an example. Is the goal specific enough? (Playing in the NBA) Is the goal measurable? (practice daily, have good study habits, make it to varsity, all-american, etc.) Is the goal attainable? (has to at least play basketball, so I suppose where this can be an endpoint for some people) Is the goal realistic? (again here, is where I think the basis of argument is stemming from, obviously they can’t be the next Michael Jordan… Or can they?) Is there a timing duration? (Play in the NBA after high school/college before age 30ish).

        We can go back and forth on the specifics of what I was trying to say. I’m just glad you were able to shock my brain to think a bit. Thanks for the thoughtful questions!

        Liked by 1 person

  3. piezoradeon says:

    This is another great insight of yours and I really love it!
    I being inferior to you (both age and experience) really look up to your blog, which I really love and would love to know that you will be doing this a long time!
    Actually, If you remember I asked you about what resident meant the other day and I ended up watching the TV show Greys Anatomy! I loved that show!
    Well, I’m mentioning that because, I happened to have seen the Bronchoscopy in it and it was cool and awesome! (I doubt I would sustain myself in the real situation, but on screen it really is fascinating!)
    I happen to have a doubt here, when you mentioned about the external locus of the student with the A+ grade, he congratulates the teacher and stuff, isn’t looking out to others for a reason for ones success better than thinking he himself was the reason he was successful?
    And during a failure it is better to think he himself was the reason and improve?
    Shouldn’t it be like during the good phase, the external locus is better and during rough periods one should be using the internal locus?
    I just wanted to clarify that… ?

    Liked by 1 person

    • doctormikesblog says:

      Thanks for the compliments! I’m happy you like my posts!

      I guess the point I was trying to make with that example was to show that by having an internal locus state of mind, we are able to have a growth mindset, and by having a growth mindset we can continue to grow. I also want to point out that these examples are black and white. In the real world, everything is on a gray scale, so it is very possible to have mixes of internal/external locus states as well as dynamic so we can be internal locus at one point and external another time. Also I’d like to clarify that there are times when having an external locus state would be better. For example, being grateful would be a good example of an external locus and would be more appropriate.

      So to summarize, the point I was trying to make is to educate on what’s been studied out there. There’s no right or wrong on these kinds of things, and I tend to refer them to as a guide to get to where I want to go. Thanks for the really insightful questions and I hope this helps!

      Liked by 1 person

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