Better: A Surgeon's Notes on Performance

Text in black are quotes; text in green are my notes. I sometimes write in Spanish.

• People underestimate the importance of diligence as a virtue. #

• THE PARADOX AT the heart of medical care is that it works so well, and yet never well enough. #

• In his view, doctors need to understand that we are businessmen—nothing less, nothing more—and the sooner we accept this the better. #

• There are vital but sometimes murky differences between acting skillfully, acting lawfully, and acting ethically. #

• Even when we don’t know that a patient can be completely normal and healthy, we want doctors to fight. #

• The seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. #

• “As a professor, you have to be a role model. You don’t want to be the cowboy who goes in to do something that your residents are not going to be able to do,” #

• He believed that excellence came from seeing, on a daily basis, the difference between being 99.5 percent successful and being 99.95 percent successful. #

• Even doctors with great knowledge and technical skill can have mediocre results; more nebulous factors like aggressiveness and diligence and ingenuity can matter enormously. #

• What is troubling is not just being average but settling for it. Everyone knows that average-ness is, for most of us, our fate. And in certain matters—looks, money, tennis—we would do well to accept this. #

• I had gone there thinking that, as an American-trained surgeon, I might have a thing or two I could teach them. But the abilities of an average Indian surgeon outstripped those of any Western surgeon I know. #

• True success in medicine is not easy. It requires will, attention to detail, and creativity. But the lesson I took from India was that it is possible anywhere and by anyone. I can imagine few places with more difficult conditions. Yet astonishing successes could be found. And each one began, I noticed, remarkably simply: with a readiness to recognize problems and a determination to remedy them. #

• better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try. #

• MY FIRST SUGGESTION came from a favorite essay by Paul Auster: Ask an unscripted question. #

  • Haz preguntas que están fuera de lo esperado. Bríncate un poco la rutina. Si en tu trabajo tienes que hablar con personas y usualmente hacer las mismas preguntas y seguir la misma rutina, varíale de vez en cuando. Tu y tus clientes lo apreciarán.

• MY SECOND SUGGESTION was: Don’t complain. #

  • No te quejes. No ganas nada quejándote si no estás dispuesto a ayudar a resolver el problema que creó la queja. Enfócate en lo que puedes controlar, lo demás déjalo pasar.

• MY THIRD ANSWER for becoming a positive deviant: Count something. #

  • Cuenta. Cuenta tus éxitos, tus fracasos, tus eventos, tus acciones, tus intentos. Pero cuenta algo.

• MY FOURTH SUGGESTION was: Write something. #

  • Escribe algo. Puede ser un diario, un blog, lo que te gusta, lo que no te gusta, lo que sea. Pero el hecho de escribir te ayuda a solidificar lo aprendido y materializar tus ideas.

• MY SUGGESTION NUMBER five, my final suggestion for a life in medicine, was: Change. #

  • Cambia. Actualízate. Mejora. Evoluciona. Aprende. Somos seres cambiantes. Tus experiencias son lo que te moldean, y podrías decir que tú no eres la misma persona de hace un mes porque has vivido más cosas. No te encierres en tus ideas, expándete.

• So find something new to try, something to change. Count how often you succeed and how often you fail. Write about it. Ask people what they think. See if you can keep the conversation going. #