I thought I knew why I came to Telluride. I was a MD/MHA dual-degree student and had some experience in the domains of quality and safety. I have followed the work of Gawande, Pronovost, and the like. I knew about checklists and what hospitals can learn from the aviation and hotel industry. I thought I came to meet the “big apostles” of quality and safety so I could hear their gospels. I thought wrong. I came to have the difficult conversations and to have a chance to be less wrong. That wasn’t the first time I was wrong on this trip. I held a false-assumption about the value of pre-clinical students at such a meeting. I remember being like them – bright eyed, limitless enthusiasm, and a burning desire to do good and change the world. But the reality and context of clinical medicine taught me valuable lessons about dealing with culture, people, and patients as they really are, rather than how you want them to be or wish they were.
However, I was humbled by the conversations with my junior future colleagues. Their naiveté was not a weakness; it was a much-needed source of critical questions. I’m about to start my role as a medical intern and like a fish, I am no longer aware of the water in which I swim. My peers forced me to critically examine clinical situations to explain the insights about context and challenges in healthcare delivery. These conversations allowed me to see the water again.
Note: Here is an animated video of a David Foster Wallace speech “This is water”. Maybe some of you will find it interesting.