Shortly after entering Medical School, in a class filled with young people who were extreme.ly skilled in accumulating facts and taking tests, it became clear in short order that no one would ever be able to fully master the material. The quantity of material was simply too great for anyone to completely understand. As well, much of the information was made obsolete between the first day of a course and the last day of the course; we were told explicitly that the half-life of our Medical Education was 7 years. Many of my classmates were terribly troubled to learn that the amount of studying that earned them 95% in college would barley earn a passing grade in Medical School. On some tests, half the class would score below 60%. It took a long time for me to realize that there was a method to the madness. Now that my Only Daughter is in Medical School it is crystal clear that there is an important purpose to many of the aspects of Medical Education. Medical School is, if anything, even more stressful today than when I was a student. The amount of information is exponentially greater and the rate of change of knowledge has accelerated. I suspect the half-life of her Medical Education is now closer to two years than to seven.
How does it benefit our patients to have Doctors who spend several years feeling overwhelmed by material? Furthermore, how does it benefit our patients to have Doctors who have spent significant amounts of time tired and over-stretched?
In fact, the preparation, perhaps inadvertently, was, and is, invaluable. Physicians are frequently faced with situations in which their information is incomplete. While most Doctor's visits turn out to be routine and predictable, in fact as we learn more and more about how the human body works, we also learn that there is much more we do not know than we do know. We are almost always operating from a knowledge deficit. Further, we must learn how to make decisions when we are not at our best. It is easy for people to do their jobs when they are at their best, but we rarely have the luxury of operating at peak efficiency. The intense stress of Medical School allows young prospective Doctors the opportunity to learn how they operate under stressful conditions, with inadequate information. Some will determine that they cannot tolerate the ambiguities involved and will enter fields where conditions are more predictable and contain a larger margin of error. The best Doctors are those who have the flexibility and resiliency to recognize that they can never know enough and can never be perfect.
This has obvious applicability to our current, seemingly interminable, process by which we choose our Presidential candidates. While there are clear differences between Doctors and Presidents, in point of fact, we need a President who can make decisions with inadequate information and when she/he is not at their best, and we need their decisions to be adequate almost all the time.
Even the most committed political junkie must be getting tired of the quasi-debates and political posturing that has been plaguing our airwaves for months. Yet the voters, in their wisdom, have so far refused to anoint a candidate in either party. This means the process will continue for at least another month and possibly until the conventions (at least on the Republican side; the Democratic primary process is unlikely to lead to an open convention, but at least for some time to come, uncertainty abounds.)
With the increasing stress on the candidates provoked by the uncertainty, we may be lucky enough to answer crucial questions in advance of actually choosing one these candidates for the position of the most powerful man or woman in the world. For example:
Will John McCain's legendary temper and self righteousness offset his history as a hero and iconoclast?
Is Mitt Romney truly as unflappable and self possessed as he appears? Is he a real person or a constructed persona?
Under pressure, will Rudy Giuliani revert to his past form as an aggressive, sometimes abusive, prosecutor who brooked no opposition?
Is Mike Huckabee more than just a pleasant, deeply religious, one dimensional candidate? Aside from his affability, does he believe in anything (in the secular realm)?
Is Fred Thompson a real candidate or an actor?
On the Democratic side, the questions are, if anything, more significant, if only because of the dearth of detail in their presentations. All three essentially support a typical liberal agenda; what about their character?
Does Hillary Clinton believe in anything except herself and the superiority of her ideas? Will she reveal (continue to reveal) her willingness to stoop to anything to achieve power or will she show some principles and humility?
Can Barack Obama be provoked into revealing anything about his positions? He appears to be the most likable candidate, is extremely well spoken, but as yet has not really said much of anything. Is that enough?
Finally, does John Edwards have anything to sell except anger? Does he believe in anything beyond himself?
The reality is that the positions of our next President, as important as such positions are, matter less than their character and their principles. The next President will face more uncertainty and more change/opportunity/danger than ever before. With luck, the next two months will offer enough opportunities for the real person hiding behind the candidate to emerge, if only for brief glimpses. Ultimately it is a person who we are voting for, not the persona.
Update: Roger Simon, perhaps because of his background as a professional writer, makes the same suggestion I have, but does it much more succinctly: The Presidential Election: A Basic Question - Cutting to the Chase
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