Locus of control involuntarily going from internal to external. (Note: this is much more of a reflection piece than the first three pieces of the series.)
Identity I: Adjectives vs. Nouns
Identity II: Use Identities to Guide Behaviors
Identity III: Automatic Connection
I injured my right elbow in April 2025. The potential causes are not important; the real effects are. My range-of-motion was reduced to a mere 80% of what is once was. I lost both flexion and extension at the ends of each, preventing me from doing my normal exercises. Even worse, the elbow can't bear any serious loads, instantly tanking me from impressive overhead press numbers to barely being able to do a simple pushup.
The injury has lasted for at least 14 weeks (t = 0 up to the time of this writing) and not gotten better since week 3. I've seen multiple doctors and they've all pretty much said it'll just take time, an unfalsifiable diagnosis that leaves me frustrated and impatiently waiting for the day I can touch my right thumb to my right shoulder and lift more than 20 pounds with a flexed arm.
I pride myself greatly on a few things, two of which are being 1) a strong-on-the-bike cyclist, and 2) strong in the gym (especially at the same time as being a good cyclist). They are both certainly driven by my ego.
And both of these prides were almost instantly destroyed. I couldn't lift weights; my right arm was atrophying at an alarming rate, enough that friends could notice even if I didn't tell them which was the bad arm. I couldn't ride my bike outside; the indoor trainer became my best friend and worst enemy, a portal to keeping fitness while constantly reminding me of what I was missing. My hobbies were almost instantly taken away from me.
Up to this point, I was very much a believer in internal locus of control, "the degree to which people believe that they, as opposed to external forces (beyond their influence), have control over the outcome of events in their lives". The injury and recovery period changed my perspective dramatically. The cause of the injury is still not obvious—not pop, no searing pain—but I suspect it came from doing some standard bicycle maintenance and struggling (muscle-wise) to finish it. Something as simple as that caused me to be out of commission for over three months despite regular elbow prehab work and being relatively careful to not do dumb stuff lest I put myself at unncessary risk. I'm now hypervigilant about protecting other parts of my body, scared about doing a small something and causing another three months of regression and having to be careful at all times to not reaggravate it.
The locus was also fully handed over to the doctors, professionals who had gone through many years of school and specialized in a specific joint and performed hundreds of surgeries on said joint. It felt like I had to convince them my elbow was not right and not getting better. (I fully recognize and appreciate that doctors must decipher which patients know their stuff and who doesn't based on very limited information and interaction. I also recognize and appreciate how difficult it is to be correct with limited information and interaction.) For example, here's the anonymized biography of my first doctor who confidently got my condition incorrect, albeit based on limited information of an X-ray and physical examination:
received recognition for earning the highest cumulative exam scores in his class and was awarded the [award] for most outstanding resident. He also received the [award] for excellence in research as a resident.
pursued additional training in sports medicine at the American Sports Medicine Institute in Birmingham, Alabama, under the direction of James R. Andrews, M.D.
Does this mean exam scores are nothing? That where they stood in their class has little real-world bearing? What about training (whatever that means—did I train under an Olympic swimmer when he gave me breaststroke advice when I was 12?) under a high-profile surgeon? Is experience all that matters on the path to becoming an expert?
I have always put doctors on a pedestal of competence. Surely they have to be more intelligent to make it through both medical school and the surgeon gauntlet, right? And if you have the intelligence you have to have the drive or vice versa? And their false positive or negative rates must be low? And the reproducibility rates are excellent? I arrived at this conclusion because I had no reason not to; all the doctors I had ever seen in my life had cured me, whether it was their doing or my body naturally recovering. We happily hand over control of ourselves to those we trust, to experts, to people who we expect will do a much better job than us.
But what happens when you realize that they aren't as good as their credentials make them out to be? That they're asking LLMs and regurgitating the response verbatim? That they're guessing and going back on the age-old heuristics of prescribing rest, ice, compression, and elevation?
My trust in credentialed experts is fractured. Rumors swirl of top schools accepting unqualified students and ensuring they pass to keep attrition rates low—why would you not want them high to show the competitiveness of the program? Top researchers falsify data to maintain their high-profile status as "top X in the world". Tradesmen who go to school for years can't troubleshoot a simple issue and resort to shotgunning the solution. The list goes on.
Credentials no longer mean the same thing they once did to me; the same should apply to most others. Show me what your track record is in whatever you do. The faster, the easier, the cheaper the fix the better. The longer it stays fixed the better. The less information you have before making an accurate diagnosis or prognosis the better. Can you do it better than the state-of-the-art LLM?
I'm forced to accept that not everything is within my control. Unfortunate accidents do happen even if I'm careful to avoid them. Inexplicable situations can arise despite me controlling as much as I can. You can only try to control so much.
Credentials matter when there's an absence of information. I still want the doctor who graduated from a prestigious university with a prestigious fellowship at a prestigious hospital over the doctor who graduated from a no-name university in the Caribbean because they weren't accepted into a name brand university. It's after they get past that filter that the real test begins.