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Sunday, March 13, 2011

Familiar vs. unfamiliar random events

I ventured out this morning and the day was glorious. The sun was out, the temperature was in the mid 60's before noon, and the flowers were blooming. I could not help to reflect at how my circumstances could not be any more different from those in Northern Japan. No place could be more suited to be prepared from this disaster. The Japanese have likely engineered their country to withstand earthquakes better than any county in the world. Their country cultivates team and non-self focused activities perhaps to a greater degree than any other place in the developed world. Yet, the devastation is amazing. We can't help but be taken aback.

How can I experience such a glorious day while at the same time there is such devastation of my friends across the globe? It is just so random!

Randomness like this grabs our attention, but we in the medical profession see this type of random bad luck every day. When a patient is referred to me for devastating illness of no fault of their own, they generally ask me why this has happened to them. While sometimes it is the product of bad decisions on their part, more often than not it is just the fact they won the wrong lottery.

While the scale of visible destruction in Japan draws attention to the effects of random back luck, the aggregate effects of illness as a consequence of bad luck in health dwarfs these intermittent and dramatic events. Within our health care world, we tend to see these unfortunate events one at a time and we are quite capable of walling off their impact on us. In some sense that is a good thing but in other respects it has pernicious effects. Were we to be devastated by every encounter with a patient impacted by illness, we could not be effective in our role as a health care professional. However, the crisis environment does tend to bring people together in ways that non-crisis circumstances do not.  Internal motivations driving people to serve others tend to generate more durable bonds that those based upon mercenary relationships.  Perhaps that is why things may need to come unglued before people can effectively work together.

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