Wednesday, December 27, 2006

A Letter to The Editor, EMJ

It is a wonderful circumstance that when a professional publication will not publish something, one can always self-publish. It may not have as wide a readership as a professional publication but time is a factor that could change that considering that web publishing is not ephemeral.

Admittedly, the letter below was part rant and part therapy, it still raised an issue that is generally important. (IMNSHO)

The Editor,

I was to sit the SAQ (Part B) on Monday 18th December. I didn't because I arrived (18 minutes) late.

I left home at 0515 to take the 0700 BA flight from Manchester to Heathrow. The flight boarded timeously but departed late (0731). From Heathrow I took the next Heathrow Express (0848), arrived Paddington 0904 and immediately took a taxi to the Barbican.

After several consultations amongst the invigilators I was told that the 15 minute rule could not be relaxed because to do so would set a precedent.

I stayed outside the doors until 1043 when the first candidate left.

I reflected.

The exception discussed could in no way be binding on any future invigilators. "Precedent" was contextually a malapropism. The exception would have done no harm and would have benefited me tremendously.

Beneficence, too, as an observed principle was conspicuously lacking.

For a professional speciality tasked primarily with the urgent, the emergent and the critical, an inflexible adherence to the letter is a cause for concern.

A society's resilience is entirely dependent on the initiative and flexibility of its constituent members....

My disappointment and frustration are salved somewhat by this letter, but the issues I raise above are material to the profession (sic) of Emergency Medicine.


E. Hassen

Friday, November 03, 2006

HBS Response: What do readers think September 2005

Two things come to mind. Plans are nothing; Planning is everything! And, the right people on the right vehicle before you select the right destination.


The rate of change accelerates and the number of disasters are only going to increase (natural and otherwise). Events cannot be predicted with a long lead time.


Every organisation needs to be more flexible, more modular, more adaptable. Large organisations especially, need to be reconfigured.


Lessons: The future is unpredictable; trust and credibility are crucially dependant on time to response - respond promptly.

Wednesday, October 04, 2006


A letter to a junior doctor:

The joys, vagaries and risks of A&E are that it is an action driven practice. The rule is “Find it, Fix it.” It is the philosophy underlying the ABCs: First things First & Find it, Fix it. It requires that you make a decision and ACT!

The caveat is act in haste, repent at leisure.

ACS is one of the big six: appendicitis, ectopic pregnancy, aortic aneurysms, acute coronary syndromes, missed fractures, and missed foreign bodies ( Everyone needs to be especially careful of these.

And everything is ultimately a learning experience.

Keep fighting the good fight J.

Sunday, October 01, 2006

Preference articulation

We don’t start out with decided preferences; we start with affinities and then we explore and articulate and refine preferences. This blog is essentially such an exploration. Articulation is itself an act of refining.

We have preferences only about things we have experienced, whether physically or psychically.

To choose we must have appreciated choices, discrete and distinguishable.

Thursday, September 28, 2006

Begin with the end in mind

A letter to junior doctors:
The purpose of learning is action and action is orientated towards a particular goal / outcome. We act to effect.
In medicine we act to determine cause or prognosis or monitor progression or we act to prevent, treat, mitigate or palliate.
It helps enormously to begin with the end in mind.
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Sunday, September 24, 2006

A thing is as it appears

This is a truism. This is a falsehood. A falsehood is not the opposite of a truism.

Simple statements are easily profound because they invite deeper engagement to lend them gravity. And truths are often simple.

We know that all that glitters is not gold but parsimony has proven utility which is why we need, consciously, to guard against it.

Appearances are everything.

We react to aggression and fear automatically with deeply ingrained biological responses. They are faster and more immediate than anything related to conscious thought.

Tuesday, August 22, 2006

Things I wish I knew

At 12

That life is largely about preparation

That knowing what you want is very important

That relationships are most important

That details matter

At 16

The 80/20 rule

That means determine ends

That control is an illusion

That purpose is to be discovered, not decided

That the world is not binary; only our language is.

That Success requires a willingness to fail.

At 21

That happiness depends on challenge

That reputation is paramount

That context is everything

That intuition is trainable

That the map is not the territory

Monday, July 10, 2006

After Action Review

What was supposed to happen?

What happened?

Why the difference?

What can we learn from this?

Monday, July 03, 2006

What to do?

To begin with the end in mind one must have an end. Sounds simple enough, but I’ve not yet found an end.

I am thinking of an end in terms of a legacy.

Have you defined your end?

Wednesday, May 17, 2006

Google Notebook

I have today begun using Google Notebook. The merits are obvious.

I already use tags for GTD/Lifehacks.

Saturday, May 13, 2006


I have a demo account with which should allow me to structure the capture of my activities related to CPD. I also have a account that I have now resolved to get and keep up to date.

I would also like to start keeping a journal regularly and have thought about this recurrently over the years. The problems have been that I am not entirely happy with my typing speed albeit faster than the average my colleagues are capable of and that recordings however easy to do are not searchable and take too long to process for review.

I have nevertheless created the following schematic:

Done today

To do

To consider

To read

To write

I also have a Google Calendar “To Read” which is very sparsely populated.

How do you capture your life? What would you recommend?

Tuesday, May 09, 2006

Taxonomies and Tagging

Posted to 3L Epiphany

The idea of a taxonomy is very interesting: a conceptual framework always helps understanding.
Taxonomy in biology makes sense because most organisms are related to those that came before. The same cannot be said of the law or blogs.
Tagging has more utility, especially for amorphous materials that can be construed in multiple ways. Tagging also allows for a more intuitive generation of concept maps.
I suggest that you find a way to let readers tag law related blogs in such a way that you (or they) can create concept maps and refine the tags.
Many have already written about the greater utility of tags compared to categories.
I do hope you find this useful.

Saturday, April 29, 2006


I’ve been thinking about trust and judgment. These are essentials that are difficult to learn and develop and teach. They are more important than data, information and knowledge. They are more tenuous and more pervasive.

Trust removes friction; so does good judgement. And friction, generally, represents a waste.

Wednesday, April 12, 2006


It has been some time since my last entry. For a while I added my reading log and then I discovered Google Desktop which automatically tracks my web browsing so I didn’t have to do it manually: that meant less mental processing of what I was reading and less blogging. Good and bad. Life is like that.

So, aware that I have to add value to readers and to myself regarding process I have revisited doing the blog. I will try.