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.

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.