‘Ring the bells that still can ring
Forget your perfect offering
There is a crack in everything
That’s how the light gets in.’
(Leonard Cohen, ‘Anthem’, from the 1992 album The Future)1
Forget the perfect offering? As I look up to the dizzying heights of perfection, I wonder if this can possibly be true. Yet, paediatrician Donald Winnicott took the parenting world by storm in the 1950s by introducing the concept of ‘good enough’:2
‘The good-enough mother … starts off with an almost complete adaptation to her infant’s needs, and as time proceeds she adapts less and less completely, gradually, according to the infant’s growing ability to deal with her failure.’2,3
He argued that the good-enough mother was better than the perfect mother. He suggested that no child needs the perfect parent. They just need the decent, good-intentioned, sometimes grumpy mother or father who loves them limitlessly. It would be fair to say that most try to offer the best for their offspring. Many feel guilty when they are not able to do so. The goal of perfection in personal and professional lives appears to be the norm in our society. The concept of ‘good enough’ is rarely recognised. Dr Winnicott’s crucial insight was that perfectionism can be cruel and counterproductive.
Could the ideals of the good-enough mother be encouraged in other aspects of life? After all, the principle of good enough (POGE) is productively used in the business world — not least in the lucrative software industry.4 But in the eyes of the medical community, and indeed the public, the notion of the good-enough doctor or the good-enough healthcare system has not been embraced. Many medics aim for perfection, while simultaneously juggling personal and professional lives. Most healthcare systems aim to offer the latest diagnostic and therapeutic tools despite mounting costs and limited resources. Striving for perfection is arguably the norm in our society and the POGE is not commonly entertained. But it would not be wrong to surmise that good enough is the best one can do in any given situation to satisfy the requirements at hand. Immanuel Kant was on to a winner when he observed that:
‘Out of the crooked timber of humanity, no straight thing was ever made.’5
Of course, there are times when perfection is called for. But, for most of the time, ‘good enough’ will do. There comes a point when more and more energy is required to achieve smaller and smaller gains. We all want to shine, accepting imperfections is difficult — and so we struggle. Reaching ‘good enough’ begins with expectation: plan an outcome that is good enough to get the job done. You can always go beyond ‘good enough’ towards ‘perfect’ — but, first, focus on building an achievable foundation stone.
Good enough is not mediocrity, or merely good. It simply means that, at the current time, all things considered, there are sufficient benefits, and no critical problems. Think of it as a means of driving continuing improvement. Achieve excellence by progressively meeting, challenging, and raising standards — not striving for the mirage of perfection. A best-practices attitude to any undertaking is to start with good enough and raise the bar to accomplish excellence — because being an excellent doctor should not compromise a good-enough personal life.
To navigate a life, and keep afloat, takes courage and skill. To persevere through the giddy challenges of children, work, and relationships is, quite frankly, heroic.
In a non-starry-eyed way, maybe we should take a step back and acknowledge that:
‘There is a crack in everything, and that’s how the light gets in.’
Good enough is good enough.
- © British Journal of General Practice 2017