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May 4, 2012

Trimming the excess

For those of you who do not play along on Twitter or even the few images I’ve posted on Facebook, I’ve been vacationing at Central Pacific Medical Center thanks to the insistence of my appendix (we’ve since parted ways). This was my first hospitalization and my first surgery, so I really encountered a lot of new experiences.

From the onset, the staff I encountered were unbelievably amicable and accommodating. Perhaps the combination of poor experiences (taking others to the hospital) and dramatizations on prime time TV left an impression of general hospitalization being function over form, care constrained by capacity. The only exception to this rule was my visit to a relative admitted to the NIH Clinical Center, which benefits from resources and capacity far greater than its demand. I’m not certain of the demand that CPMC serves, but being in the center of San Francisco and open to the public (NIH is clinical research referral only) I expect it to be greater than that found in Bethesda. Additionally, I’m guessing that federal funding levels between NIH and Sutter Health are quite different as well.

Even so, the approach and atmosphere was strikingly similar. People smiled and laughed with you—and each other. Things didn’t seem rushed or harried at all (perhaps all Wednesday nights are slow; I don’t know). And perhaps it was due to reading The Checklist Manifesto previously, but I loved the overlap that everyone did to make sure that no opportunity for error or confusion could slip in. Everyone confirmed what had been done, and nothing was left for the next person; every vital check happened the exact same way, and every update or change came with a check of my wristband to confirm my identity. It was really bulletproof and made me feel safe.

There’s something about living life with precision that is both awe-inspiring and repulsive. I can look at the system in place at CPMC and know that it raises the quality of their care, yet at the same time I can see tons of reasons why any given person would want to skip the routine and just get things done: for a sense of free will, for faster results, and so on. In my personal life as well, I’d love to have this same kind of rote processing but I rebel agains becoming a machine.

Do we as humans really want perfection? Perhaps we haven’t really grasped the concept that optimization reduces the number of viable options available. We, therefore, look at choice as freedom when, in truth, it increases propensity to failure. If someone were truly able to show us the one true Way, how many would take it?

So here I sit, in an environment that shows me the real benefits of precision, rebelling against my own efforts to optimize. Yet I’ll persist; for this experience has given me multiple points of reset—places where I’ll have to stop for a while, start again—that perhaps can be improved. I’m going to have to restrict my activities while I heal; why not reform them as well? Perhaps I’ll get to a place where my life is precise enough that I can start focusing on accuracy. Maybe I’ll even be able to rid myself of some unnecessary appendages (see what I did there?) along the way.

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