A soldier cannot run from battle because there are guns trained on his back in both directions.

This is not so in other occupations. As medical students and professionals, we constantly have to choose how to react to new information and whether to take action or to sit on the sidelines. Soldiers don’t have the luxury of these options. So in a way, because we must make difficult choices, we also need to muster more courage to perform in the battlefield.

Patient safety improvement takes a lot of guts. It means challenging the status quo, confronting established traditions, risking your job or grades, and most of all, dealing with recalcitrant people….who may be your seniors.

Today I was confronted about my experience shadowing a preceptor who does not wash his hands before he sees patients. I have commented on this directly to the physician by saying, “I notice that you don’t wash your hands between patients, this is different from what we learned in school.” This did not change his behavior, but I did notice that he would wash his hands after he saw me do it first. I have been rather passive about confronting my preceptor again, but I think that I have renewed determination after these eye-opening conversations at Telluride. The strategies of CUS and DESC will certainly be helpful.

Good leaders set priorities and make decisions. The Telluride patient safety camp is doing more than informing us, it is training us to be leaders – those will not turn back in the face of adversity, those will fight against apathy, and those who will be soldiers who cannot turn back because they see no choice but to push on.