Mea sententia

For all my friends and colleagues at CMHC (with deepest apologies to Lerner and Lowe)…

All I want is a place somewhere,

Not locked down by Committee Chairs,

Where all who want can go to share,

Now wouldn't that be loverly?

Lots of documents for us to read.

Lots of communication, indeed.

Where creativity can breed.

Oh, wouldn't it be loverly?

Oh, so loverly as we all collaborate at will

We would never need to budge

For stuff that thrills like a sleeping pill.

Sir William Osler famously said: “Listen to the patient. He is trying to tell you what ails him.”

The German philosopher Hegel said, “We learn from history that we don’t learn from history.”

The process of becoming a physician is a long and gradual process. Scattered through this glacially slow and often painful process are episodes that are transformational in every sense of the word, experiences that impact what kind of physician one becomes. Or even, whether or not one becomes a physician. 

I keep a bar of soap in my desk at the office as a reminder of progress in medical care. It was my grandfather’s idea.

It played out more like a television skit than most television skits. I wouldn’t believe it myself had I not been there.

“When you pay a lot of money for bullshit, you have to pretend you like how it smells. To do otherwise is to admit you were wrong, and that is not allowed in management.”

From STAR-Whacked at Trustus Pharmaceuticals. 

Life must be understood backward. But it must be lived forward. (Soren Kierkegaard)

I struggle with how best to approach attentional issues in my practice. I was taught by a developmental pediatrician in Madison that (diagnostic) labels were a convenience invented to make things simpler for clinicians and the billing office, but that they are of limited clinical value. and often actually harmful to patients. His concerns centered on the dangers of standardization and the dead-end effect. Treating the label distracts from seeing and treating the patient as a unique individual in a unique context with an individual manifestation of X.

Not all errors have negative consequences. Many go unnoticed. Occasionally they save lives.