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Cause of Death: EGO, Opinion Based Psychoanalytical Approach of Ego in Medicine

Jaren Jarrell | FP-C, CCEMT-P, NRP

Twitter is the most raw, emotional, and informational social media platform out there. Most of the time, it’s someone arguing over ketamine doses or what COVID-19 treatment is the best based on their political association or opinion. Providers hide behind a pseudonym and post egotistical comments about others downplaying the learning minds. In a rare case, someone may agree with you and retweet to start an intellectual conversation. Not bashing Twitter, but if you know, you know. 

So we ask ourselves the somewhat obvious question, does EGO play a role within the medical field. OF COURSE, it does! 

So, where does this stem from? After dusting off some freshman year college textbooks, I found this guy named Dr. Sigmund Freud; you may have heard of him. Dr. Sigmund Freud was a neurologist and, more importantly, the founder of psychoanalysis. Psychoanalysis, simply put, is the study of the unconscious mind, i.e why we do what we do. This theory is explained easiest through three different concepts; instincts, reality, and morality, represented through an image of an iceberg. 

Now the iceberg theory makes sense, but let’s break this down to be more relevant. Love it, or hate it, but The Office is a great example. You have two main characters that truly represent the battle between the Id and Superego, creating unique personalities. 

The psychoanalytic theory consists of the ID, SUPEREGO, and EGO. 

The ID- Micheal Scott (The child, instinctive) 

The Id represents primitive and instinctive decisions or being impulsive. The ID responds directly to biological needs and urges. Think of a small child, impatient and thrives off biological needs. When they do not get what they want, they cry or show distress. This all dwells in the unconscious mind and is always with the person. 

SUPEREGO- Toby Flenderson (Moral Compass)

This represents a more subtle and kinder approach. It incorporates the morals and values of the society, which are typically inherited from parents and the general norm. The superego acts as the angel to the devilish ideas of the ID. If society forbids intense sexualization and aggression, the superego turns these actions into something morally correct in the current society. Think of the angel and devil. 


The ego acts like you in the current state of mind. Deciding subconsciously what is morally right but also satisfying your primitive/biological needs. Taking in concepts from both the ID and SUPEREGO, the EGO makes the most logical decision. The EGO is also heavily impacted by societal norms, self-actualization, and achievements. Hence the medical profession hot heads. 

Where does the medical profession go wrong?

There is a thin line between confidence and ego. We tend to confuse confidence with an overactive ego because it fulfills the ID and pleasure-seeking principles. 

Confidence                               Egotistical

Self-assurance                          Dunning-Kruger effect

Belief                                                    Constant fear

Ability to perform                             Best of the Best mentality

Rehearsed                                           Self-Absorbed

Able to hand over the torch            Their well-being vs. others

There needs to be a precise balance of knowledge and ego to perform at the highest level. Providers can easily fall into concepts of imposter syndrome or the Dunning Kruger effect. Imbalance can affect the confidence to perform or the inability to perform at one’s level. 

Why are we like this???

It boils down to our personality types. Look at the HEMS world, we are all super confident, Type A, slit your throat to land a job type providers, but our greatest critic is staring back at us through the mirror in front of us.  

Type A                                       Type B

Competitive                                         Not competitive

Organized, time managed                        Creative

Self Critical                                                Relaxed

These Type A personalities lead to a competitive environment where every alpha dog thrives. This leads to putting patient care into the shadows only to bost ourselves in the light. 

Everyone wants to be published; everyone wants to be verified on Twitter. The management of critical patients that produce favorable outcomes fulfills that need for organization and the drive for competition within a type A. “ The best of the best” These concepts dump into the EGO and fuel the ID. 

We die to see our name in print, and the competition serves as a breeding ground for egotistical behavior. With the focus on our flawed EGO, Maslow’s “self-actualization” theory presents itself more important than life. At this point, all other blocks of the pyramid suffer. 

These personality traits lead us back to the ID and our pleasure principle. Eventually, this can affect patient care and life itself. We end up focusing on the success of others with constant comparison. Doubting ourselves with toxic self-criticism and always wondering what our value is to others and if it’s enough. We should keep all of these traits in mind but obviously, step back and shift focus back on the core concepts of personal well-being, mutual relationships, self-worth, reputation, and, more importantly, patient care. 

Remember to be better. 

Remember we do this for the patient, not the publication. 


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