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.
Atul GawandeThis is the reality of intensive care: at any point, we are as apt to harm as we are to heal.
Atul GawandeYou want to ensure people can do it right 99 percent of time. When we have to fire one of our surgical trainees, it is never because they dont have the physical skills but because they dont have the moral skills - to practise and admit failure.
Atul GawandeI said there are at least two kinds of satisfaction, however, and the other has nothing to do with skill. It comes from human connection. It comes from making others happy, understanding them, loving them.
Atul GawandeDonโt let yourself be. Find something new to try, something to change. Count how often it succeeds and how often it doesnโt. Write about it. Ask a patient or a colleague what they think about it. See if you can keep the conversation going.
Atul GawandeWhat 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.
Atul Gawande