Coaching Done Well May Be

I Think The Extreme Complexity Of Medicine Has Become More Than An Individual Clinician Can Handle. But Not More Than Teams Of Clinicians Can Handle.

The Definition Of What It Means To Be Dying Has Changed Radically. We Are Able To Extend People's Lives Considerably, Including Sometimes, Good Days.

What Is Needed, However, Isn't Just That People Working Together Be Nice To Each Other. It Is Discipline. Discipline Is Hard--harder Than Trustworthiness And Skill And Perhaps Even Than Selflessness. We Are By Nature Flawed And Inconstant Creatures. We Can't Even Keep From Snacking Between Meals. We Are Not Built For Discipline. We Are Built For Novelty And Excitement, Not For Careful Attention To Detail. Discipline Is Something We Have To Work At.

We've Created A Multitrillion-dollar Edifice For Dispensing The Medical Equivalent Of Lottery Tickets - And Have Only The Rudiments Of A System To Prepare Patients For The Near Certainty That Those Tickets Will Not Win. Hope Is Not A Plan, But Hope Is Our Plan.

One Of The Reasons People Might Be Fallible, Why We Might Fail To Do What We Try To Do Isignorance, That We Have A Limited Understanding Of The Laws Of The World - The Physical Laws That Govern The World And Of All The Particulars Of The World Upon Which Those Laws Work. And Then There's Ineptitude, Meaning That The Knowledge Is Available, But Individuals Fail To Apply It Correctly. The Third Source Is "necessary Fallibility." That Is, We're Never Going To Be Omniscient, There Is Some Knowledge That We Will Simply Never Achieve, And There Are Limits To What We Will Be Able To Do.