Sublime

As a result of regulatory, cultural, and financial obstacles, doctors and nurses who aspire to be upstreamists on the front lines face challenges in five key areas. To remember these, think of the acronym TRIDNTT (pronounced “trident”): 1. Time and Resources (both human and capital) 2. Incentives (at individual and system levels) 3. Data that’s acc

There are three basic elements of this cultural challenge: a lack of sociocultural competence; the skewed demographic composition of our health care workforce and its cultural implications (that is, a lack of diversity); and a lack of mentorship.

As documented by Sherwin Nuland, clinical professor of surgery at Yale University and National Book Award winner for How We Die: Reflections on Life’s Final Chapter, many Americans have fallen prey to the idea, now avidly marketed by many big players in the health care industry, that medicine can offer a remedy to nature.

I began reading literature again: Solzhenitsyn’s Cancer Ward, B. S. Johnson’s The Unfortunates, Tolstoy’s Ivan Ilyich, Nagel’s Mind and Cosmos, Woolf, Kafka, Montaigne, Frost, Greville, memoirs of cancer patients—anything by anyone who had ever written about mortality.

It’s ludicrous, though, to suppose that checklists are going to do away with the need for courage, wits, and improvisation. The work of medicine is too intricate and individual for that: good clinicians will not be able to dispense with expert audacity. Yet we should also be ready to accept the virtues of regimentation.

Consider this informal test to assess certain types of ailments, and whether a modern “fix” is called for: In environments similar to the one I am living in, did people suffer from this ailment prior to modern medicine? If yes, a novel solution is warranted. If no, look to history for the solution. Take rickets as an example, for someone of Europea

Until the 20th century, wealthy households in China retained a well-known physician to be on constant call for the entire family, much as major corporations today retain renowned attorneys. The physician would visit the household regularly to check everyone’s health, dispense preventive advice and formulas, check on diets and personal habits, and g

first began to understand health as a social phenomenon that starts and ends outside the clinic walls.