If you know the lesion and know yourself, your recovery will not stand in doubt

Regard your soldiers as your children, and they will follow you into the deepest valleys; look upon them as your own beloved sons, and they will stand by you even unto death.

If, however, you are indulgent, but unable to make your authority felt; kind-hearted, but unable to enforce your commands; and incapable, moreover, of quelling disorder: then your soldiers must be likened to spoilt children; they are useless for any practical purpose.

If we know that our own men are in a condition to attack, but are unaware that the enemy is not open to attack, we have gone only halfway towards victory.

If we know that the enemy is open to attack, but are unaware that our own men are not in a condition to attack, we have gone only halfway towards victory.

If we know that the enemy is open to attack, and also know that our men are in a condition to attack, but are unaware that the nature of the ground makes fighting impracticable, we have still gone only halfway towards victory.

Hence the experienced soldier, once in motion, is never bewildered; once he has broken camp, he is never at a loss.

Hence the saying: If you know the enemy and know yourself, your victory will not stand in doubt; if you know Heaven and know Earth, you may make your victory complete.

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:

Talking in the surgery terms, however, it should be able to apply to other field, too.

Translation:

Regard your clinicians as your children, and they will follow you into the deepest valleys; look upon them as your own beloved sons, and they will stand by you even unto death.

If, however, you are indulgent, but unable to make your authority felt; kind-hearted, but unable to enforce your commands; and incapable, moreover, of quelling disorder: then your clinicians must be likened to spoilt children; they are useless for any practical purpose.

If we know that our own men are in a condition to treat, but are unaware that the lesion is not open to attack, we have gone only halfway towards recovery.

If we know that the lesion is open to attack, but are unaware that our own men are not in a condition to attack, we have gone only halfway towards recovery.

If we know that the lesion is open to attack, and also know that our men are in a condition to attack, but are unaware that the nature of the informed consent makes treatment impracticable, we have still gone only halfway towards recovery.

Hence the experienced clinician, once in motion, is never bewildered; once he has broken sterilised packages, he is never at a loss.

Hence the saying: If you know the lesion and know yourself, your recovery will not stand in doubt; if you know Heaven and know Earth, you may make your recovery complete.

Ray Murakami

The population immunity of the country is the clinician's best ally

The natural formation of the country is the soldier's best ally; but a power of estimating the adversary, of controlling the forces of victory, and of shrewdly calculating difficulties, dangers and distances, constitutes the test of a great general.

He who knows these things, and in fighting puts his knowledge into practice, will win his battles. He who knows them not, nor practices them, will surely be defeated.

If fighting is sure to result in victory, then you must fight, even though the ruler forbid it; if fighting will not result in victory, then you must not fight even at the ruler's bidding.

The general who advances without coveting fame and retreats without fearing disgrace, whose only thought is to protect his country and do good service for his sovereign, is the jewel of the kingdom.

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:

Translated as the public/population health policy.

Translation:

The population immunity of the country is the clinician's best ally; but a power of estimating the adverse events, of controlling the forces of immunisation, and of shrewdly calculating difficulties, dangers and distances, constitutes the test of a great clinical director.

He who knows these things, and in fighting puts his knowledge into practice, will win his battles. He who knows them not, nor practices them, will surely be defeated.

If treatment is sure to result in recovery, then you must treat, even though the ruler forbid it; if treatment will not result in recovery, then you must not treat even at the ruler's bidding.

The clinical director who advances without coveting fame and retreats without fearing disgrace, whose only thought is to protect his country and do good service for his population, is the jewel of the health system.

Ray Murakami

Now a team is exposed to six several calamities, not arising from natural causes, but from faults for which the clinical director is responsible

Now an army is exposed to six several calamities, not arising from natural causes, but from faults for which the general is responsible. These are: (1) Flight; (2) insubordination; (3) collapse; (4) ruin; (5) disorganization; (6) rout.

Other conditions being equal, if one force is hurled against another ten times its size, the result will be the flight of the former.

When the common soldiers are too strong and their officers too weak, the result is insubordination. When the officers are too strong and the common soldiers too weak, the result is collapse.

When the higher officers are angry and insubordinate, and on meeting the enemy give battle on their own account from a feeling of resentment, before the commander-in-chief can tell whether or not he is in a position to fight, the result is ruin.

When the general is weak and without authority; when his orders are not clear and distinct; when there are no fixes duties assigned to officers and men, and the ranks are formed in a slovenly haphazard manner, the result is utter disorganization.

When a general, unable to estimate the enemy's strength, allows an inferior force to engage a larger one, or hurls a weak detachment against a powerful one, and neglects to place picked soldiers in the front rank, the result must be rout.

These are six ways of courting defeat, which must be carefully noted by the general who has attained a responsible post.

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:

Following the previous section about discourse between the patient and the physician, this section discusses communication between clinical leaders and common clinicians.

Translation:

Now a team is exposed to six several calamities, not arising from natural causes, but from faults for which the clinical director is responsible. These are: (1) Flight; (2) insubordination; (3) collapse; (4) ruin; (5) disorganization; (6) rout.

Other conditions being equal, if a team is hurled against a demand ten times its capacity, the result will be the flight of the former.

When the common clinicians are too strong and their medical officers too weak, the result is insubordination. When the medical officers are too strong and the common clinicians too weak, the result is collapse.

When the higher officers are angry and insubordinate, and on meeting the patients give treatment on their own account from a feeling of resentment, before the chief medical officer can tell whether or not he is in a position to treat, the result is ruin.

When the clinical director is weak and without authority; when his orders are not clear and distinct; when there are no fixes duties assigned to officers and men, and the ranks are formed in a slovenly haphazard manner, the result is utter disorganization.

When a clinical director, unable to estimate the volume and nature of demand, allows an understaffed team to engage a larger one, or hurls an inexperienced detachment against a difficult one, and neglects to place picked clinicians in the front rank, the result must be rout.

These are six ways of courting defeat, which must be carefully noted by the clinical director who has attained a responsible post.

Ray Murakami

We may distinguish six kinds of ground of discourse

Sun Tzu said: We may distinguish six kinds of terrain, to wit: (1) Accessible ground; (2) entangling ground; (3) temporizing ground; (4) narrow passes; (5) precipitous heights; (6) positions at a great distance from the enemy.

Ground which can be freely traversed by both sides is called accessible.

With regard to ground of this nature, be before the enemy in occupying the raised and sunny spots, and carefully guard your line of supplies. Then you will be able to fight with advantage.

Ground which can be abandoned but is hard to re-occupy is called entangling.

From a position of this sort, if the enemy is unprepared, you may sally forth and defeat him. But if the enemy is prepared for your coming, and you fail to defeat him, then, return being impossible, disaster will ensue.

When the position is such that neither side will gain by making the first move, it is called temporizing ground.

In a position of this sort, even though the enemy should offer us an attractive bait, it will be advisable not to stir forth, but rather to retreat, thus enticing the enemy in his turn; then, when part of his army has come out, we may deliver our attack with advantage.

With regard to narrow passes, if you can occupy them first, let them be strongly garrisoned and await the advent of the enemy.

Should the army forestall you in occupying a pass, do not go after him if the pass is fully garrisoned, but only if it is weakly garrisoned.

With regard to precipitous heights, if you are beforehand with your adversary, you should occupy the raised and sunny spots, and there wait for him to come up.

If the enemy has occupied them before you, do not follow him, but retreat and try to entice him away.

If you are situated at a great distance from the enemy, and the strength of the two armies is equal, it is not easy to provoke a battle, and fighting will be to your disadvantage.

These six are the principles connected with Earth. The general who has attained a responsible post must be careful to study them.

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:

Beginning of the new chapter. Train is translated into ground of discourse between the patient and the physician.

Translation:

Sun Tzu would have said: We may distinguish six kinds of ground of discourse, to wit: (1) Accessible ground; (2) entangling ground; (3) temporizing ground; (4) narrow passes; (5) precipitous heights; (6) positions at a great distance from the patient.

Ground which can be freely traversed by both sides is called accessible.

With regard to ground of this nature, be before the patient in occupying the raised and highlighted topics, and carefully guard your line of arguments. Then you will be able to communicate with advantage.

Ground which can be abandoned but is hard to re-occupy is called entangling.

From a position of this sort, if the patient is unprepared, you may sally forth and drive him away. But if the patient is prepared for your coming, and you fail to drive him away, then, return being impossible, disaster will ensue.

When the position is such that neither side will gain by making the first move, it is called temporizing ground.

In a position of this sort, even though the patient should offer us an attractive bait, it will be advisable not to stir forth, but rather to retreat, thus enticing the patient in his turn; then, when part of his next of kin has come out, we may deliver our terms with advantage.

With regard to narrow passes, if you can occupy them first, let them be strongly garrisoned and await the advent of the patient.

Should the patient forestall you in occupying a pass, do not go after him if the pass is fully garrisoned, but only if it is weakly garrisoned.

With regard to precipitous heights, if you are beforehand with your adversary, you should occupy the raised and highlighted topics, and there wait for him to come up.

If the patient has occupied them before you, do not follow him, but retreat and try to entice him away.

If you are situated at a great distance from the patient, and the strength of the two parties is equal, it is not easy to provoke a debate, and fighting will be to your disadvantage.

These six are the principles connected with faith. The physician who has attained a responsible post must be careful to study them.

Ray Murakami

He who exercises no forethought but makes light of emergency scenarios is sure to be overwhelmed by them

If our troops are no more in number than the enemy, that is amply sufficient; it only means that no direct attack can be made. What we can do is simply to concentrate all our available strength, keep a close watch on the enemy, and obtain reinforcements.

He who exercises no forethought but makes light of his opponents is sure to be captured by them.

If soldiers are punished before they have grown attached to you, they will not prove submissive; and, unless submissive, then will be practically useless. If, when the soldiers have become attached to you, punishments are not enforced, they will still be useless.

Therefore soldiers must be treated in the first instance with humanity, but kept under control by means of iron discipline. This is a certain road to victory.

If in training soldiers commands are habitually enforced, the army will be well-disciplined; if not, its discipline will be bad.

If a general shows confidence in his men but always insists on his orders being obeyed, the gain will be mutual.

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:

Translated in terms of staffing to demand and enforcing best practices based on evidence.

Translation:

If our staff are no more in number than the demand, that is amply sufficient; it only means that no severe shortage can occur. What we can do is simply to concentrate all our available strength, keep a close watch on the sudden demand surge, and obtain reinforcements.

He who exercises no forethought but makes light of emergency scenarios is sure to be overwhelmed by them.

If patients are held accountable before they have grown attached to you, they will not prove compliant; and, unless compliant, then will be practically hopeless. If, when the patients have become attached to you, compliance is not enforced, they will still be hopeless.

Therefore patients must be treated in the first instance with humanity, but kept under control by means of the best practice. This is a certain road to recovery.

If in explaining patients best practices are habitually enforced, the treatment will be well evidence-based; if not, its outcome will be bad.

If a physician shows faith in his patients but always insists on best practices being obeyed, the gain will be mutual.

Ray Murakami