Tuesday 25 February 2014

The clever consultant looks to the effect of a multidisciplinary team

Thus one who is skillful at keeping the enemy on the move maintains deceitful appearances, according to which the enemy will act. He sacrifices something, that the enemy may snatch at it.

By holding out baits, he keeps him on the march; then with a body of picked men he lies in wait for him.

The clever combatant looks to the effect of combined energy, and does not require too much from individuals. Hence his ability to pick out the right men and utilize combined energy.

When he utilizes combined energy, his fighting men become as it were like unto rolling logs or stones. For it is the nature of a log or stone to remain motionless on level ground, and to move when on a slope; if four-cornered, to come to a standstill, but if round-shaped, to go rolling down.

Thus the energy developed by good fighting men is as the momentum of a round stone rolled down a mountain thousands of feet in height. So much on the subject of energy.


From "Sun Tzu on the Art of War - The Oldest Military Treatise in the World"
Translated from the Chinese By Lionel Giles, M.A. (1910)

Discussion:

This is the summary section of this chapter about engagement. The first part is about the engagement between the clinician and the patient and put in the mobile care context. The second and the last part is about engagement within clinical team and put in the context of the multidisciplinary team.

Translation:

Thus one who is skilful at keeping the patient on the move maintains the online presence, according to which the patient will access. He provides some information, that the patient may snatch at it.

By holding out portals, he keeps the patient informed; then with a clinic of picked staff he calls in the patient for an appointment.

The clever consultant looks to the effect of a multidisciplinary team, and does not require too much from individuals. Hence his ability to pick out the right people and utilise a multidisciplinary team.

When he utilises a multidisciplinary team, his staff become as it were like unto rolling logs or stones. For it is the nature of a log or stone to remain motionless on level ground, and to move when on a slope; if four-cornered, to come to a standstill, but if round-shaped, to go rolling down.

Thus the engagement developed by good clinical team is as the momentum of a round stone rolled down a mountain thousands of feet in height. So much on the subject of engagement.

Ray Murakami

Saturday 15 February 2014

The good medical officer will be comprehensive in his onset, and prompt in his decision

The onset of troops is like the rush of a torrent which will even roll stones along in its course.

The quality of decision is like the well-timed swoop of a falcon which enables it to strike and destroy its victim.

Therefore the good fighter will be terrible in his onset, and prompt in his decision.

Energy may be likened to the bending of a crossbow; decision, to the releasing of a trigger.

Amid the turmoil and tumult of battle, there may be seeming disorder and yet no real disorder at all; amid confusion and chaos, your array may be without head or tail, yet it will be proof against defeat.

Simulated disorder postulates perfect discipline, simulated fear postulates courage; simulated weakness postulates strength.

Hiding order beneath the cloak of disorder is simply a question of subdivision; concealing courage under a show of timidity presupposes a fund of latent energy; masking strength with weakness is to be effected by tactical dispositions.


From "Sun Tzu on the Art of War - The Oldest Military Treatise in the World"
Translated from the Chinese By Lionel Giles, M.A. (1910)

Discussion:

For the second time, I changed the English translation of the title of this chapter to fit it into healthcare context. Now it is Engagement. The original translation was "energy" and I thought it means what moves a lot of people in a coordinated way after considering this section. In healthcare, what brought people on the same page is engagement. There are many other expressions required creative translations. Those were about the "deceptive" nature of the war which makes enemy believe what is actually not. I have chosen anaesthesia, sedation and relaxant as such elements in healthcare.

Translation:

The onset of a treatment is like the rush of a torrent which will even roll stones along in its course.

The quality of decision is like the well-timed swoop of a falcon which enables it to strike and destroy its victim.

Therefore the good medical officer will be comprehensive in his onset, and prompt in his decision.

Engagement may be likened to the bending of a crossbow; decision, to the releasing of a trigger.

Amid the turmoil and tumult of treatment, there may be seeming disturbance and yet no real disturbance at all; amid confusion and chaos, your array may be without head or tail, yet it will be proof against defeat.

Induced unconsciousness postulates perfect consciousness, induced calmness postulates vitality; induced weakness postulates strength.

Hiding consciousness beneath the cloak of coma is simply a question of anaesthetics; concealing vitality under a show of timidity presupposes a fund of latent energy by sedation; masking strength with weakness is to be effected by relaxant.

Ray Murakami