Viva la revolución

Making systems work is the great task of our generation.

This quote is paraphrased from the ideas in Atul Gawande’s 2012 TED talk titled “How do we heal medicine?” (which by the way you should watch if you haven’t already), but in the setting of today’s discussion it feels more relevant than ever.

If my aforementioned pre-med life as an engineer sparked my interest in safety and quality, Gawande’s writing fanned the flames during medical school. When I started medical school, my incoming class was given a copy of his book Better to read before orientation. Now shortly after graduating from medical school it seems fitting that we’ve touched on the five suggestions he gave at the end of that book (ask an unscripted question, don’t complain, count something, write something, change).

As I enter residency, I’m happy to have found many sources of inspiration here in Telluride, including the great John J. Nance. We are privileged to have John with us here in Telluride, and today we discussed many of the ideas presented in his book Why Hospitals Should Fly, which we were given a copy to read before arriving in Telluride. One major takeaway for me was realizing the extent of and feeling energized by the rising revolution in health care, away from its founding principles of independence and autonomy. We must move from “Doctors using their best SKILLS in service of PATIENT’S BEST INTERESTS” to “Doctor providing the best MEDICAL CARE AVAILABLE to MEDICAL SCIENCE”.

John also shared a powerful personal story about leadership, safety, and advocacy which I just loved. I won’t do it justice, but I’ll try to give a quick summary. As a high ranking commander huddling with the crew of a large military plane, John noticed a young crew member with no military rank who was clearly intimidated by John’s high rank (when they shook hands John said he had “eyes like fried eggs” – what a great expression). John demonstrated true leadership by binding the people together into a team and creating a safe environment for any member of the crew to speak up, and that empowered this young crew member to raise a concern that saved everyone from a major mistake and tragedy. His message, “Don’t let that small voice go silent”, reminded me of the deep-rooted reason we all go into health care – to help others and advocate for those who can’t.

What a wonderful way to bookend my medical school experience and consider ways to incorporate reflection and mindful engagement into my future training and professional development.