We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the...

In the end, people don’t view their life as merely the average of all its moments—which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a...

Betterment is perpetual labor. The world is chaotic, disorganized, and vexing, and medicine is nowhere spared that reality. To complicate matters, we in medicine are also only human ourselves. We are distractible, weak, and given...

I love you.”People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others,...

Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.

The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And,...

We want progress in medicine to be clear and unequivocal, but of course it rarely is. Every new treatment has gaping unknowns – for both patients and society – and it can be hard to...

Few societies have come to grips with the new demography. We cling to the notion of retirement at sixty-five – a reasonable notion when those over sixty-five were a tiny percentage of the population but...

If there is a credo in practical medicine, it is that the important thing is to be sensible.

There is a saying about surgeons, meant as a reproof: “Sometimes wrong; never in doubt.” But this seemed to me their strength. Each day surgeons are faced with uncertainties. Information is inadequate; the science is...

The possibilities and probabilities are all we have to work with in medicine, though. What we are drawn to in this imperfect science, what we in fact covet in our way, is the alterable moment-the...

The core predicament of medicine – the thing that makes being a patient so wrenching, being a doctor so difficult, and being a part of society that pays the bills they run up so vexing...

Are doctors who make mistakes villains? No, because then we all are.

We’re always trotting out some story of a ninety-seven-year-old who runs marathons, as if such cases were not miracles of biological luck but reasonable expectations for all. Then, when our bodies fail to live up...

The striking thing is that WHO doesn’t really have the authority to do any of this. It can’t tell governments what to do. It hires no vaccinators, distributes no vaccine. It is a small Geneva...

To become a doctor, you spend so much time in the tunnels of preparation–head down, trying not to screw up, just going from one day to the next–that it is a shock to find yourself...

This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.

Pain is a symphony – a complex response that includes not just a distinct sensation but also motor activity, a change in emotion, a focusing of attention, a brand-new memory.

A study led by the Harvard researcher Nicholas Christakis asked the doctors of almost five hundred terminally ill patients to estimate how long they thought their patient would survive, and then followed the patients. Sixty-three...

People underestimate the importance of dilligence as a virtue. No doubt it has something to do with how supremely mundane it seems. It is defined as “the constant and earnest effort to accomplish what is...

We want autonomy for ourselves and safety for those we love. That remains the main problem and paradox for the frail. Many of the things that we want for those we care about are things...

One American in seven has no coverage, and one in three younger than sixty-five will lose coverage at some point in the next two years. These are people who aren’t poor or old enough to...