Such failures carry an emotional valence that seems to cloud how we think about them. Failures of ignorance we can forgive. If the knowledge of the best thing to do in a given situation does not exist, we are happy to have people simply make their best effort. But if the knowledge exists and is not applied correctly, it is difficult not to be infuriated. What do you mean half of heart attack patients don’t get their treatment on time? What do you mean that two-thirds of death penalty cases are overturned because of errors? It is not for nothing that the philosophers gave these failures so unmerciful a name—ineptitude. Those on the receiving end use other words, like negligence or even heartlessness.
I have been trying for some time to understand the source of our greatest difficulties and stresses in medicine. It is not money or government or the threat of malpractice lawsuits or insurance company hassles—although they all play their role. It is the complexity that science has dropped upon us and the enormous strains we are encountering in making good on its promise.
The problem is not uniquely American; I have seen it everywhere—in Europe, in Asia, in rich countries and poor. Moreover, I have found to my surprise that the challenge is not limited to medicine.
I have been trying for some time to understand the source of our greatest difficulties and stresses in medicine. It is not money or government or the threat of malpractice lawsuits or insurance company hassles—although they all play their role. It is the complexity that science has dropped upon us and the enormous strains we are encountering in making good on its promise.
The problem is not uniquely American; I have seen it everywhere—in Europe, in Asia, in rich countries and poor. Moreover, I have found to my surprise that the challenge is not limited to medicine.
Here, then, is our situation at the start of the twenty-first century: We have accumulated stupendous know-how. We have put it in the hands of some of the most highly trained, highly skilled, and hardworking people in our society. And, with it, they have indeed accomplished extraordinary things.
Nonetheless, that know-how is often unmanageable. Avoidable failures are common and persistent, not to mention demoralizing and frustrating, across many fields—from medicine to finance, business to government. And the reason is increasingly evident: the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.
Nonetheless, that know-how is often unmanageable. Avoidable failures are common and persistent, not to mention demoralizing and frustrating, across many fields—from medicine to finance, business to government. And the reason is increasingly evident: the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.
There is perhaps no field that has taken specialization further than surgery. Surgeons are so absurdly ultraspecialized that when we joke about right ear surgeons and left ear surgeons, we have to check to be sure they don’t exist. I am trained as a general surgeon but, except in the most rural places, there is no such thing.
You really can’t do everything anymore. I decided to center my practice on surgical oncology— cancer surgery—but even this proved too broad. So, although I have done all I can to hang on to a broad span of general surgical skills, especially for emergencies, I’ve developed a particular expertise in removing cancers of endocrine glands.
You really can’t do everything anymore. I decided to center my practice on surgical oncology— cancer surgery—but even this proved too broad. So, although I have done all I can to hang on to a broad span of general surgical skills, especially for emergencies, I’ve developed a particular expertise in removing cancers of endocrine glands.
Expertise is the mantra of modern medicine. In the early twentieth century, you needed only a high school diploma and a one-year medical degree to practice medicine. By the century’s end, all doctors had to have a college degree, a four-year medical degree, and an additional three to seven years of residency training in an individual field of practice—pediatrics, surgery, neurology, or the like. In recent years, though, even this level of preparation has not been enough for the new complexity of medicine. After their residencies, most young doctors today are going on to do fellowships, adding one to three further years of training in, say, laparoscopic surgery, or pediatric metabolic disorders, or breast radiology, or critical care. A young doctor is not so young nowadays; you typically don’t start in independent practice until your midthirties.
Lacrimas
Valles Marineris, Battle Scar of Mars
Valles Marineris is a 4000-km long, and 7 km deep valley in Mars. It's the largest valley in the solar system.
Forwarded from Nerdy med students
“Hippocampus”
is the greek word for “seahorse”
اللي هوَ حصان البحر مدري شسمه
“Hippos” meaning horse
“Kampos” meaning sea monster
is the greek word for “seahorse”
اللي هوَ حصان البحر مدري شسمه
“Hippos” meaning horse
“Kampos” meaning sea monster
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— Watchmen Chapter 9: The Darkness of Mere Being
As far as we can discern, the sole purpose of human existence is to kindle a light of meaning in the darkness of mere being.
— Carl Jung
— Carl Jung