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

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

My own son has a congenital heart condition, where his life was saved by a cardiac surgeon stepping in at 11 days of life to save his life. But he is now 21 years old because of constant monitoring and working with him with a primary care physician. that's the only reason now that he's getting to live a long and healthy life. That's what we're not rewarding. They don't have the kind of resources and commitment that we are giving to people like me. I have millions of dollars of equipment available to me when I go to work every day in an operating room.

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.

When I do an operation, it's half a dozen people. When it goes beautifully, it's like a symphony, with everybody playing their part.

Are doctors who make mistakes villains? No, because then we all are.

One of the reasons people might be fallible, why we might fail to do what we try to do isignorance, that we have a limited understanding of the laws of the world - the physical laws that govern the world and of all the particulars of the world upon which those laws work. And then there's ineptitude, meaning that the knowledge is available, but individuals fail to apply it correctly. The third source is "necessary fallibility." That is, we're never going to be omniscient, there is some knowledge that we will simply never achieve, and there are limits to what we will be able to do.