When [disease] Can't Be Stopped,

You Can't Make A Recipe For Something As Complicated As Surgery. Instead, You Can Make A Recipe For How To Have A Team That's Prepared For The Unexpected.

I Talked To Over Two Hundred Patients And Family Members About Their Experiences With Aging, Serious Illnesses, And The Big Unfixables. But I Also Spoke With Scores Of Physicians, And Especially Geriatricians, Palliative Care Doctors, Hospice Nurses, And Nursing Home Workers. The Biggest Thing I Found Was That When These Clinicians Were At Their Best, They Were Recognizing That People Had Priorities Besides Merely Living Longer. The Most Important And Reliable Way That We Can Understand What People's Priorities Are, Besides Just Living Longer, Is To Simply Ask. And We Don't Ask.

You Know, 97 Percent Of The Time, If You Come Into A Hospital, Everything Goes Well. But Three Percent Of The Time, We Have Major Complications.

Sometimes We Can Offer A Cure, Sometimes Only A Salve, Sometimes Not Even That. But Whatever We Can Offer, Our Interventions, And The Risks And Sacrifices They Entail, Are Justified Only If They Serve The Larger Aims Of A Person's Life. When We Forget That, The Suffering We Inflict Can Be Barbaric. When We Remember It The Good We Do Can Be Breathtaking.

You Want To Ensure People Can Do It Right 99 Percent Of Time. When We Have To Fire One Of Our Surgical Trainees, It Is Never Because They Dont Have The Physical Skills But Because They Dont Have The Moral Skills - To Practise And Admit Failure.