Purpose

What if life could be understood forwards? What if you could see the shape of your life now, well before its end?

 

I walked this path and left a legacy….

 

Sculptors often say that they do no more than liberate the sculpture rather than create. Can a life be sculpted in the same way? The means can be varied infinitely towards the same end.

 

What tools, whose hands and how long?

 

My question, essentially, is how early in life can you know or discover your purpose? If you know that your life’s work cannot begin until you know what it is, how can you go about discovering it sooner?

First principles

As an intern I thought that ill patients took precedence over everything: meetings, eating, sleep… because what could be more important? I mean ill patients, not dying patients. Most patients in hospital don’t die and those who do are usually not unexpected or avoidable deaths. Some may argue this as a self-esteem issue, but I think it was no more than a wrong-priority issue.

 

As a first year SHO I learnt that my learning took precedence and I wasn’t entirely comfortable with that. I understood that doing the wrong things was worse than not doing anything, but not-doing just did not feel right.

 

Now I know and understand that Hazards-Hello-Help is the right and necessary order, but I don’t always remember or apply it: and my failure is not machismo.

 

I know that balance is important and that First Principles are FIRST: first things first: only a fool insists on tying his shoelaces in a fiercely burning building. Having said that, stress narrows our cognitive focus acutely so that we cannot remember things we know very well.

 

This post is because of the reason I left work late this morning, at 0h35, and walked home in the rain. It was quite pretty.

Lean Learning

This is borrowed from Lean Manufacturing or just-in-time manufacturing: no inventory. It is just-in-time learning as opposed to just-in-case learning, the premise being that know-why (judgement) is most important and that know-how is next and that know-what can always be looked up.

Many years ago, I was surprised to learn that Einstein did not know the mass of the earth. It wasn’t necessary to know it because it was referenced. It took more time and effort then to look up something like that than it does today. Knowing it remains unnecessary.

In medicine practice is supposed to be informed by the evidence, but for most of medicine there is no evidence. Where cause and effect are proximate, common-sense serves; where they are not it does not. We have already picked all the low hanging fruit of proximate effects. We are in uncharted territory with huge numbers of patients and small effects and a severely constrained cognitive biology.

What is the solution? More data and more sophisticated data mining and a more pervasively statistical perspective. Never, of course, forgetting human and humane engagement.