We've Created A Multitrillion-dollar Edifice For Dispensing

We Recruit For Attitude And Train For Skill.

We Look For Medicine To Be An Orderly Field Of Knowledge And Procedure. But It Is Not. It Is An Imperfect Science, An Enterprise Of Constantly Changing Knowledge, Uncertain Information, Fallible Individuals, And At The Same Time Lives On The Line. There Is Science In What We Do, Yes, But Also Habit, Intuition, And Sometimes Plain Old Guessing. The Gap Between What We Know And What We Aim For Persists. And This Gap Complicates Everything We Do.

Our Reluctance To Honestly Examine The Experience Of Aging And Dying Has Increased The Harm We Inflict On People And Denied Them The Basic Comforts They Most Need.

Writing Lets You Step Back And Think Through A Problem. Even The Angriest Rant Forces The Writer To Achieve A Degree Of Thoughtfulness.

Making Systems Work Is The Great Task Of My Generation Of Physicians And Scientists. But I Would Go Further And Say That Making Systems Work - Whether In Healthcare, Education, Climate Change, Making A Pathway Out Of Poverty - Is The Great Task Of Our Generation As A Whole.