I chose surgery because I thought that perhaps this would make me more like the kind of person I wanted to be.

We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.

Just look at the list of who the lowest-paid people are. Pediatricians are at the bottom. You would also look at internists. You would look at psychiatrists. You would look at family physicians, HIV specialists. People who take care of chronic illnesses by seeing people carefully over time, those are the people who get the least money. The people who have the most are people like orthopedic surgeons, interventional cardiologists. And my point isn't that there is something wrong with heroism.

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.

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

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.

And in stories, endings matter.