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.

Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.

If we took away the ability to put defibrillators in people in their last years, people would be shouting in the streets.

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.

In every industrialized nation, the movement to reform health care has begun with stories about cruelty.

In psychology, there's something called the broken-leg problem. A statistical formula may be highly successful in predicting whether or not a person will go to a movie in the next week. But someone who knows that this person is laid up with a broken leg will beat the formula. No formula can take into account the infinite range of such exceptional events.

We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.