V. ENGAGEMENT

1. The healthcare of a large population is the same principle as the healthcare of a few patients: it is merely a question of catering for individual needs.

2. Treating with a large health organisation under your command is nowise different from treating with a small one: it is merely a question of instituting effective health information systems.

3. To ensure that your whole population may withstand the outbreak of the infectious diseases and remain unshaken-- this is effected by immunisations targeted and standard.

4. That the effectiveness of your health team may be like a grindstone dashed against an egg--this is effected by the science of indications and contraindications.

5. In all healthcare deliveries, the direct method may be used for the first encounter, but remote methods will be needed in order to maintain access.

6. Remote deliveries, efficiently applied, are ubiquitous as Heaven and Earth, continuous as the flow of rivers and streams; like the sun and moon, they are timely and repeatable; like the four seasons, they accommodate any stages of life.

7. There are not more than sixteen bits, yet the combinations of these can record more melodies than can ever be heard.

8. There are not more than eight bits each for three primary colours, yet in combination they can record video streams with more hues than can ever been seen.

9. There are not more than blood-oxygen level test, yet pulse oximetry yield more favours than other methods ever be tested.

10. In healthcare, there are not more than two methods of delivery--the direct and the remote yet these two in combination give rise to an endless series of manoeuvres.

11. The direct and the remote lead on to each other in turn. It is like moving in a circle--you never come to an end. Who can exhaust the possibilities of their combination?

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

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

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

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

16. 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.

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

18. 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.

19. 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.

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

21. 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.

22. 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.

23. 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.

Translated from the Chinese By Lionel Giles, M.A. (1910)

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