My vantage point on the world is the operating room where I see my patients.

As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.

No one looks at your hands to see how much they shake when you are interviewed to be a surgeon. The physical skills required are no greater than for writing cursive script. If an operation requires so much skill only a few surgeons can do it, you modify the operation to make it simpler.

For a writer, you definitely do not want to be in the mainstream. You want to be on the edge because that's where the vantage point is. That's where you can see.

If I get hit by a bus tomorrow, my patients will not even be postponed. Another surgeon would step in and take over. The reason to do research and writing is that it at least makes me feel not entirely replaceable. If I didn't write, I don't know if I would do surgery.