My blog represents my personal experiences and perspectives. This includes many anecdotes from my life and from my medical practice. I have been scrupulous to anonymize all medical anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
I have been getting lots of requests for ‘my opinion’ about the novel coronavirus pandemic, where we are now, and what is coming. Here goes:
My family, friends, and colleagues know I speak out or act up when I see something I think is wrong. When asked why, my usual answer is that I was raised to examine and question things, to seek information, to make up my own mind, and to always behave in a way that is true to my values.
This explanation is true but incomplete, as it fails to convey my belief that silence is a form of acceptance and can be tantamount to endorsement. I offer an anecdote from my childhood as an illustration of what I mean.
Me (in my head): You should go for a run.
Me (in my head): But it's raining.
Me (in my head): What's your point?
Me (in my head): But it's raining.
Me (out loud): I should go for a run.
Spouse: Why don't you?
Me: It's raining.
Spouse: Oh.
Me: I used to like to run in the rain.
Spouse: What changed?
Me: I got older.
Spouse: But what changed about running in the rain.
Me: I don't relish discomfort anymore.
Spouse: LOL.
Pause...changes into running gear.
Me (back from run in the rain): That was great!
We Americans like to think (and boast) about our great experiment in Democracy: that we are a nation founded on the principle so famously expressed by Thomas Jefferson that all are created equal and endowed by God from birth with an unalienable right to life, liberty, and the pursuit of happiness.
As they say these days: not so much.
I have a question for white folks reading this: Have you or your family benefitted from affirmative action laws or policies? If your answer is ‘no’ I wonder if you will feel differently after reading this post.
This is Derek Sivers' version of a quote based on the opening of a David Foster Wallace address* to the 2005 graduating class at Kenyon College:
This is a brilliant article. It focuses on health inequity, but applies quite well to to a wide range of things, including education, justice, housing, voting, finance, and governance. Here's my distillation of the message:
"...we must build a deeper understanding of racism as a system of advantage — otherwise our ... efforts are bound to simply remain diversity and inclusion projects."
I precipitated a recent online discussion about healthcare’s obsession with measurement (quality metrics is the current buzz phrase) when I quoted two aphorisms that highlight some problems with metrics and targets:
Goodhart's Law: "When a measure becomes a target, it ceases to be a good measure,"
Campbell's Law: "The more a metric is used, the more likely it is to "corrupt the process it is intended to monitor."
One comment rubbed me the wrong way because it implied that measurement reduces harm:
I apologize but sometimes one has to test things.
I’ve always loved satire. The official definition is “…the use of humor, irony, exaggeration, or ridicule to expose and criticize people's stupidity or vices, particularly in the context of contemporary politics and other topical issues.” I like to think of it as weaponized humor. Despite being a target-rich environment, medical writing has far less than its rightful share of good satire. When good medical satire comes around, I enjoy it.