Quadrant of Frustration

What I’m going to talk about is probably more complex than a quadrant. There’s probably a Z-axis that I can’t think of (or don’t want to think about, because then it would go to a classification of 8 instead of 4, but I can’t visually represent that). Maybe I’m being intellectually simplistic, but y’all are just gonna have to DEAL WITH IT.


I was a Chemistry major in college. I went to a Liberal Arts school, so despite my science oriented degree, I actually have a Bachelor of Arts in Chemistry. We used to joke at Knox (although I’m sure it wasn’t unique to us at all) that I “had a B.A., but it feels more like BS.” Don’t laugh, it’s not really funny.

I worked hard at my studies. I did honors work for a chemist who is now one of my closest friends. His field was analytical chemistry; so I was an “anal chemist.” (I was working on trying to detect penicillin derived products in milk). Again, don’t laugh; this is just for my amusement. I liked analytical chemistry. It was maybe the most “practical” of all the subsets (organic, inorganic, physical, etc…) There were rules. If you paid close attention and could focus on details, you could be useful very expeditiously. It fit my sensibilities.

Prof. Welch, my advisor, mentor, and friend. The picture is of Bob Kooser, a physical chemist at Knox who died during my junior year.

(Since the picture is above, I’ll add this quick aside. Prof. Kooser gave the best lectures. PChem is HARD. Some of it, in the early days, involved a lot of theoretical/though experiements. He would tell us to put our pens down, and give a 30 minute talk on the intersection of physics, chemistry, and philosophy – and it was amazing. He gave the students his home phone number so we could call him if we were stuck on our homework. I made the mistake of calling on a Sunday, during a Bears game one time. I did not repeat the mistake. 20 years later, I still miss that man and his duct-tape jeans).

One of my most intellectually stimulating classes was in my senior year. I took Advanced Inorganic Chemistry. I’m surprised I liked it because it was all the things my research was not. It was abstract. It was extensively theoretical. And it made me do something that I’m not very good at. I really had to think in 3D. We had to describe different types of symmetry for large and complex molecules. When we took tests (there were four of us in the class), you could see us with our pencils vertically in the air, trying to spin and flip imaginary structures in our mind. It was draining. And helpful. But difficult.

I had a hard time in surgery in medical school; I wasn’t very good at suturing at first. Organic chemistry was hard. Inorganic chemistry was hard. I think the common denominator is that my eyes and visual processes are very much in a 2D world. I can’t draw to save my life; I don’t know how to show depth. All of these areas require being able to visualize things in 3D. I can’t show the famous “z-axis” that mathematicians love. One of my longest friends, Jay Reeves, spent a semester in Greece. He gave my family a beautiful sketch of some ruins. “Wow, that must have taken you hours!” I  know I told him that. His response? “Nah! It took my twenty minutes. Our professor told us to draw all the vertical lines we saw.” I could have stood there for days and not have made progress. I routinely lose to kindergarteners when playing Pictionary. I’m not proud, but it’s not pretty.

This is a long explanation for my topic. What I’m going to talk about is probably more complex than a quadrant. There’s probably a Z-axis that I can’t think of (or don’t want to think about, because then it would go to a classification of 8 instead of 4, but I can’t visually represent that). Maybe I’m being intellectually simplistic, but y’all are just gonna have to DEAL WITH IT.

I still enjoy problem solving. I like solving puzzles. No matter what’s in the future for career #2 for me (and I’m getting close… more on that some other time), I still want to help solve problems. I like dissecting problems, brainstorming, and then trying out solutions. It’s intellectually stimulating and keeps my brain cells on their toes.

Here’s the thing. Problem solving can be really frustrating, too. Especially so when you fail. When things don’t go well, when there’s a bad outcome, I rack my brain for a very long time. It hinges, at least as I see it, on two conditions.

-Is the problem set in your purview? Is it in your knowledge set? Can you do something about it? This is my X-axis.

-Here’s the other thing, you can only address a problem in your knowledge set IF you see it coming. So, could you see it coming? Should have you?

Not all frustration is the same, at least, not to me. One type is not worse than the other types. It’s just different. But there’s also an opportunity for a different type of learning in each area. So, let me break this down for a second.

Quadrant I: Is the problem in your knowledge set? (Yes) Should have you seen it coming? (Yes)

OK, this sucks. Basically, you commit both errors. You should have known better, and you should have anticipated it. It’s the ultimate screw up, you know it, and there’s no hiding from it. You need to apologize. Hell, you WANT to apologize. But it seems insufficient. The conclusion in this quadrant? You’re a dumbass, no two ways about it. In my old world, this is Medical Malpractice 101.

Here’s the redeeming quality about this quadrant. You have the most to learn and grow from here. You re-study and double check your knowledge base. You anticipate more, stay on alert for the future scenarios similar to this one. You can get better, and probably will, as long as you don’t stink at one-trial learning. In some ways, of the four quadrants, it’s the only one where you SHOULD feel guilty… not that the others don’t have their obnoxious qualities.

Quadrant II: Is the problem in you knowledge set? (Yes) Should have you seen it coming? (No)

Have you ever been in the situation where you could have helped someone IF YOU ONLY JUST KNEW? This is quadrant II. You have the knowledge and ability to help someone, but it really was impossible for you to even to deal with the problem. There’s nothing to feel guilty about, I suppose. But you still feel terrible. Why? Because it feels like you were set up to fail. It’s like seeing a child with influenza after they’ve been sick for 5 days with influenza. They’re too late for antivirals, and they’re well on their way to secondary pneumonia. If the child had just been brought to you earlier, this could have been avoided.

You don’t feel guilty. You feel profound sadness. The area of growth here is more difficult because you need systemic changes to get a different outcome. You need a better switchboard operator to get you the information faster. You need to find a way to be in-the-know more expeditiously. There’s tremendous growth possible, IF you can do the root cause analysis.

Quadrant III:  Is the problem in your knowledge set? (No) Should have you seen it coming? (Yes)

This is watching the trainwreck and being powerless to stop it. The problem at hand isn’t in your court. It’s not your problem. It’s not your subject. So, you should feel good, right? Not so fast… you can see the problem, if only other people could intervene. You’ve been here before, so why won’t somebody just do something?

This is like calling DCFS in a way when there’s a concern about abuse. You have enough suspicion that there’s a serious problem, so you risk your neck and report it. You can’t directly prove it, but deep down, you KNOW something’s wrong. Now you just need the caseworkers to do their thing. Problem is that the bar is set so high, the kid stays in the environment. And 6 months or a year later, you get a really shitty phone call about the child is now in more trouble. You did your part. You tried your best. It should have been good enough, but now…

This one leads to the most anger, at least for me. It feels like if you just had one more person in your corner, you could have changed something. But it’s not your call, so you have to hope that other people see and believe what you (in your soul) already know. Again, there’s long-term growth potential here, but it also requires systemic change, and depending on where you work and what you do, that may or may not happen.

Quadrant IV:  Is the problem in your knowledge set? (No) Should have you seen it coming? (No)

On first inspection, you could argue that this doesn’t even belong on the quadrants. It’s not your problem, and it really was hidden. You aren’t guilty. This shouldn’t even be on your mind. BUT…

This quadrant seems like it carries the most catastrophic negative outcomes. It’s why I’m writing the article. A few months ago, there was a case in Illinois about a child (young, elementary aged) that died in a hospital, and weighed under 20 pounds at the time. If you looked at message boards on the case (and by the way, don’t do that, the worst comments in the world are thrown up on these newspaper feeds), there was a lot of somewhat justifiable rage? Why didn’t the school know? Why didn’t a doctor say something? Where were the other family members and why didn’t they step in?

I won’t comment on this specific case, in part because I don’t know the specifics. But it is representative of the really evil, bad, twisted stuff in the world. This brings real tried and true anguish. The number of things that have to change to avoid a similar occurrence seems insurmountable. It seems like you’d have to be omnipotent and have insomnia to change the outcome. It’s not your fault, but you sure as hell don’t feel any better.

There’s probably a third element (at least) that would turn the quadrant into a box. I don’t know what that third axis is, and I may not want to know. I have a hard time thinking about and breaking down an eight part box. But I’m sure someone smarter could break it down and deal with the more specific emotions. I still like helping and figuring out the puzzle. I’ve learned to forgive myself and grow from where I was wrong. It, however, does not make undesirable results easier to cope with. The silver lining, I suppose, is now that I’ve identified it, is that I can begin to let some of the quadrants go. Please, don’t let there be a Z-axis. I don’t think I have the requisite brain power to figure that one out.

Author: Jason Kesselring

I am a 40 year old pediatrician on sabbatical, happily married, and a father of two wonderful children. I fell out of the Ugly Tree, and hit every branch on the way down.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s