This Was Not Guilt: Guilt Is What

Over Time I Learned That There Are Two Very Different Satisfactions That You Can Have In Your Life. One Is The Satisfaction Of Becoming Skilled At Something. It Almost Doesn't Matter What The Terrain Is. There Is A Deep, Soul-feeding Resonance In Mastery Itself, Whether In Teaching, Writing A Complicated Software Program, Coaching A Baseball Team, Or Marshalling A Group Of People To Start A New Business.

Once You Start To Ask Patients About Their Priorities, You Discover What They're Living For. Once You Uncover That, It Helps You, As A Doctor, Decide What To Fight For. And When We Do That, We Often End Up Identifying Limits To The Kind Of Care That People Want. One's Assumption Is That These People Are Going To Live Shorter Lives, But What We're Doing Is Protecting Quality Of Life. In Doing So, You Sometimes End Up Helping People Live Longer. Certainly, You Help People Live Better Days And With More Purpose In Their Lives.

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.

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.

Practice Is Funny That Way. For Days And Days, You Make Out Only The Fragments Of What To Do. And Then One Day You've Got The Thing Whole. Conscious Learning Becomes Unconscious Knowledge, And You Cannot Say Precisely How.