What is the alternative to understanding the complexity of the world?

Outsiders tend to be the first to recognize the inadequacies of our social institutions. But, precisely because they are outsiders, they are usually in a poor position to fix them.

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.

The evidence is that people who enter hospice don't have shorter lives. In many cases they are longer.

We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets - and have only the rudiments of a system to prepare patients for the near certainty that those tickets will not win. Hope is not a plan, but hope is our plan.

After readinf some essay on the nature of human fallibility, I was very aware that we are the recipients of a huge amount of discovery over the last century. Medicine exemplifies this. And that has transitioned us from a world in which people's lives were mostly governed by ignorance to one that's constrained by ineptitude. A century ago, we didn't know, for instance, what diseases afflicted us, what their nature really was, or what to do about them. And that has changed.

Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need.