Friday, March 16, 2012


There are days when you're not your best. Everybody has them. The editor misses a typo. The accountant forgets an extra deduction. No one expects perfection. We are human after all. Our bodies are wired to expertly sort through the morass of physical and emotional data and develop a game plan.

We do this all the time. The subtlety of human thought and judgement touch on such banalities as which shirt will go with which shoes, which turn will avoid the morning rush hour traffic.

So many thousands of crossroads heaped on the pile of our daily decision making process. And unlike computers, we are prone to lapses. The consequences are usually minor. One may suffer a fashion emergency or get scolded for sauntering into work a few minutes late. One may even lose their job.

No one looks forward to these events, but they are recoverable.

Sometimes there are periods of darkness. When the lapses seem to be less the exception and more the rule. The decision process leaves the realm of the unconscious and becomes a screaming adversary that pummels us at every turn.

As a physician, I face these times with great uncertainty. Because unlike the editor or the accountant, my decisions have life altering consequences. On the good days, I accept my own fallibility as an occupational hazard. I suspect the benefit of my efforts far out weigh the harms.

But the devil is often in the details. I sometimes choke, sputter, and gag on the noxious fumes that fill the office. Sometimes the diagnosis is wrong, the brain is addled, or the hand is clumsy.

It's at these times, I pray to follow the great dictum and "do no harm".

And I hunker down and brace myself to deal with the consequences,

come what may.

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