Do the right thing

One of the very first morality lessons we learn in life is that morality is not dependent on observation. Quite simply, we should always do what's right, not just when people are watching. This sounds pretty trite, but in reality, this can be really hard sometimes.

As a resident, I had a patient who was critical, and the family for this patient was so irritating. I just couldn't stand them. And I knew that if I played my cards right, I could convince them to change the patient's code status to comfort care, so the family would get off my back, and I could get some sleep on call.

As a student, I could've written all of my notes without ever examining my patients. No one was checking the accuracy of my findings. Who would've ever known?

And as an attending, I find myself put into dubious situations, where I am presented with disability or FMLA forms or other nightmare paperwork, and it would be so easy to just check off a few boxes and call it a day.

Unfortunately, you can't do the right thing only when it's convenient. And so, sometimes medicine sucks. No one ever said doing the right thing was going to be easy, but it makes it a lot easier to sleep at night.


Medicine is all about making decisions, but in the course of medical education, we are never actually taught how to make decisions. It is implied, as if this is a skill that we come born with. But that's not true. You have to learn how to make a decision.

The one thing that so many doctors experience is not a lack of information, but too much. We gather reports, lab tests, x-rays, repeat x-rays, repeat lab tests, consultations, and all in the effort to make a decision. And as we hem and haw, the issue becomes moot. We are paralyzed by information. And suddenly we are second guessing ourselves, and withdrawing previous decisions, favoring another.

And most of the time when we're paralyzed like this, we end up being right by doing nothing. Voltaire said it best: "The art of medicine consists in amusing the patient while nature cures the disease."

If you like to read Malcolm Gladwell, he writes a lot on decision making, and all the things that we use to make a decision, and it is scary to realize that what I had for lunch that day may be more influential to my plan of care than anything in the patient's chart.