Your very large team of doctors will see you now -

Your very large team of doctors will see you now


This commencement address by Atul Gawande, the practicing physician who writes about medicine for The New Yorker, has been getting a lot of attention. It paints a perhaps-dispiriting portrait of modern medicine as a matter of frequent routine practiced by large interactive teams. Not a lot of room for Dr. House in this world:

“There is resistance, sometimes vehement resistance, to the efforts that make it possible. Partly, it is because the work is rooted in different values than the ones we’ve had. They include humility, an understanding that no matter who you are, how experienced or smart, you will fail. They include discipline, the belief that standardization, doing certain things the same way every time, can reduce your failures. And they include teamwork, the recognition that others can save you from failure, no matter who they are in the hierarchy.

“These values are the opposite of autonomy, independency, self-sufficiency. Many doctors fear the future will end daring, creativity, and the joys of thinking that medicine has had.”

Gawande, of course, thinks creativity still has its place in this world. David Brooks, who has lately shown limited interest in explaining in explaining how politicians work and more interest in figuring out how societies do, extrapolates Gawande’s lesson to a broader argument: Individualism is overrated.

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Your very large team of doctors will see you now

  1. David Brooks – “Worst of all, they are sent off into this world with the whole baby-boomer theology ringing in their ears …. Most successful young people don’t look inside and then plan a life. They look outside and find a problem, which summons their life. …. Today’s grads enter a cultural climate that preaches the self as the center of a life. But, of course, as they age, they’ll discover that the tasks of a life are at the center.”

    Individualism is not bad, people are mostly moral. And everyone is an individual so it is impossible to avoid individualism. Humans form civil society – we help others naturally.

    Problem is that boomers taught their child, and now grand children, to be more libertine than libertarian.

    Selfish individualism – give people fish because it feels good to feed starving people. Also allows you to control other people because you’re in charge of food supply.

    Non-selfish individualism would teach people to fish so they can feed themselves in future, be self sufficienct.

    Boomers want people to focus on self but that’s not how humans are, we are compassionate and caring. Plenty of individuals do things for others without reward.

    “On the whole human beings want to be good, but not too good, and not quite all the time ~ George Orwell”

    David Brooks:  More important, their lives have been perversely structured. This year’s graduates are members of the most supervised generation in American history ….. Yet upon graduation they will enter a world that is unprecedentedly wide open and unstructured … No one would design a system of extreme supervision to prepare people for a decade of extreme openness.”

    Atul Gawande – “These values are the opposite of autonomy, independency, self-sufficiency. Many doctors fear the future will end daring, creativity, and the joys of thinking that medicine has had.”

    Virginia Postrel:

    Stasist social criticism—which is to say essentially all current social criticism—brings up the specifics of life only to sneer at or bash them. Critics assume that readers will share their attitudes and will see contemporary life as a problem demanding immediate action by the powerful and wise.

    This relentlessly hostile view of how we live, and how we may come to live, is distorted and dangerous. It overvalues the tastes of an articulate elite, compares the real world of trade-offs to fantasies of utopia, omits important details and connections, and confuses temporary growing pains with permanent catastrophes. 

    It demoralizes and devalues the creative minds on whom our future depends. And it encourages the coercive use of political power to wipe out choice, forbid experimentation, shortcircuit feedback, and trammel progress.

  2. Yes, a very complex world….and about to get even more complex with the knowledge age upon us.  So it requires teams, not cowboys.

    And a great deal more technology.

    Once we have more technology in place, things will get a whole lot better, but right now we’re going over the hump.

    “The future is already here – it’s just not very evenly distributed.” William Gibson

  3. It’s a good thing parents of high ability children continue to avoid the fair-play rules that have saturated academics and athletics these days.  High achievers and those who can recognize and nurture them will continue to drive human development.

    • Who are these high achievers you are referring to?  Could they be people like Tiger Woods and Kobe Bryant who think, perhaps because of their parents avoidance of “the fair-play rules that have saturated academics and athletics these days”, that they are above behaving with integrity in personal lives.  No matter how brilliant a person is academically, they can always learn something from those around them that have experienced something they have not.  

      • I was referring to those high achievers that live, study, compete and work locally near me and near everyone in this world.  They particularly don’t include those you mention in your reply that are foisted upon us by the MSM.  Those I try to ignore since they do not in my mind drive human development.  I was referring to those achievers that strive for excellence in their achievements.  Boorish behaviour is exhibited by persons of all abilities.  Parents of gifted children slyly avoid Harrison Bergeron activities while paying lip-service to equality of outcome.

  4. That column is typical Brooks. Take someone else’s idea, add some platitudes, recycle.

    The man has been wrong about everything, Iraq, the economy, Applebees, etc…

    He is an idiot