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

Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength.

We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right - one after the other, no slipups, no goofs, everyone pitching in.

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

If the conversation people think is coming is the 'death panel' conversation, that's a total failure.

Having great components is not enough, and yet we've been obsessed in medicine with components. We want the best drugs, the best technologies, the best specialists, but we don't think too much about how it all comes together.