This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.

Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.

I chose surgery because I thought that perhaps this would make me more like the kind of person I wanted to be.

Arriving at an acceptance of one's mortality is a process, not an epiphany.

As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything--a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps--the ones that even the highly skilled professional using them could miss. Good checklists are, above all, practical.