At best, the final product of our work, attention and learning is a hypothesis, an educated guess. We give antibiotics to some who don't need them and withhold antibiotics from some who do. We react to positive tests of little value and ignore negative tests of great significance. Frequently, we treat disorders that don't exist and miss those that threaten lives, even when they come in belt-high and beautiful, tempting as a hanging curve ball. Uncertainty and unpredictability govern great expanses of medicine.
Perfection is unattainable.
Failure is inherent in what we do, so we need to learn how to live with it. I remember that as he stepped up to the plate in the last inning of the la st game of the season, he looked at me out on the mound and, lifting the bat off his shoulder to ready himself for the first pitch, gave me a small smile. To understand the courage behind that smile, you have to know that Matthew, the only boy on the team who had never played baseball before, had not reached first base safely in the last six weeks. Matthew took endless batting practice, worked with his mother after school at home and listened carefully to every tip I could feed him. But his muscle groups refused to agree on how to get the bat and ball together over the strike zone.