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

If the team sees an advantage to be gained and makes no effort to secure it, the members are exhausted

When the soldiers stand leaning on their spears, they are faint from want of food.

If those who are sent to draw water begin by drinking themselves, the army is suffering from thirst.

If the enemy sees an advantage to be gained and makes no effort to secure it, the soldiers are exhausted.

If birds gather on any spot, it is unoccupied. Clamor by night betokens nervousness.

If there is disturbance in the camp, the general's authority is weak. If the banners and flags are shifted about, sedition is afoot. If the officers are angry, it means that the men are weary.

When an army feeds its horses with grain and kills its cattle for food, and when the men do not hang their cooking-pots over the camp-fires, showing that they will not return to their tents, you may know that they are determined to fight to the death.

The sight of men whispering together in small knots or speaking in subdued tones points to disaffection amongst the rank and file.

Too frequent rewards signify that the enemy is at the end of his resources; too many punishments betray a condition of dire distress.

To begin by bluster, but afterwards to take fright at the enemy's numbers, shows a supreme lack of intelligence.

When envoys are sent with compliments in their mouths, it is a sign that the enemy wishes for a truce.

If the enemy's troops march up angrily and remain facing ours for a long time without either joining battle or taking themselves off again, the situation is one that demands great vigilance and circumspection.

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:

Yet another tricky part. Descriptions of enemy soldiers are turned into those of clinicians regardless of the sides because those descriptions are mostly about motivations and morales.

Translation:

When the clinicians stand leaning on their stools, they are faint from want of food.

If those who are sent to draw water begin by drinking themselves, the team is suffering from thirst.

If the team sees an advantage to be gained and makes no effort to secure it, the members are exhausted.

If students gather on any spot, it is unoccupied. Clamor by night betokens nervousness.

If there is disturbance in the unit, the director's authority is weak. If the banners and flags are shifted about, sedition is afoot. If the officers are angry, it means that the members are weary.

When a team fills their stomaches with grain bars and kills their laptops for shutdown, and when the men do not leave their coffee-pots over the stoves, showing that they will not return to their desks, you may know that they are determined to complete the long procedure.

The sight of men whispering together in small knots or speaking in subdued tones points to disaffection amongst the rank and file.

Too frequent rewards signify that the team is at the end of his resources; too many punishments betray a condition of dire distress.

To begin by plaster, but afterwards to take fright at the test result numbers, shows a supreme lack of intelligence.

When envoys are sent with compliments in their mouths, it is a sign that the other service wishes for a staffing support.

If the other service's staff march up angrily and remain facing ours for a long time without either joining care or taking themselves off again, the situation is one that demands great vigilance and circumspection.

Ray Murakami

Resource proposals unaccompanied by a sworn budgeting indicate a plot

Humble words and increased preparations are signs that the enemy is about to advance. Violent language and driving forward as if to the attack are signs that he will retreat.

When the light chariots come out first and take up a position on the wings, it is a sign that the enemy is forming for battle.

Peace proposals unaccompanied by a sworn covenant indicate a plot.

When there is much running about and the soldiers fall into rank, it means that the critical moment has come.

When some are seen advancing and some retreating, it is a lure.

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:

Another challenging part. Here the enemy is translated into health policies which often cause headache to health professionals.

Translation:

Humble words and increased preparations are signs that the new health policy is about to advance. Violent language and driving forward as if to the attack are signs that the policy will be discarded.

When the temporary plans come out first and take up a position on the budget, it is a sign that the policy is forming for reform.

Resource proposals unaccompanied by a sworn budgeting indicate a plot.

When there is much running about and the secretaries fall into offices, it means that the critical moment has come.

When some are seen advancing and some retreating, it is a lure.

Ray Murakami

If their place of residence is easy of access, they are tendering a home care

When the enemy is close at hand and remains quiet, he is relying on the natural strength of his position.

When he keeps aloof and tries to provoke a battle, he is anxious for the other side to advance.

If his place of encampment is easy of access, he is tendering a bait.

Movement amongst the trees of a forest shows that the enemy is advancing. The appearance of a number of screens in the midst of thick grass means that the enemy wants to make us suspicious.

The rising of birds in their flight is the sign of an ambuscade. Startled beasts indicate that a sudden attack is coming.

When there is dust rising in a high column, it is the sign of chariots advancing; when the dust is low, but spread over a wide area, it betokens the approach of infantry. When it branches out in different directions, it shows that parties have been sent to collect firewood. A few clouds of dust moving to and fro signify that the army is encamping.

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 exactly a difficult one. See how well it worked.

Translation:

When the intake population is close at hand and remains quiet, they are relying on the natural strength of their service access.

When they keep aloof and try to provoke a home visit, they are anxious for the other side to advance.

If their place of residence is easy of access, they are tendering a home care.

Movement amongst the trees along the driveway shows that the service users are advancing. The appearance of a number of faces in the midst of thick glass windows means that the service users wants to make us hurry.

The rising of siren with the flashlights is the sign of an ambulance. Scattered cars indicate that a emergency vehicle is coming.

When there is the number of visits rising in a winter, it is the sign of the flu advancing; when the number is low, but spread over a wide area, it betokens the efficacy of the herd immunity. When it branches out in different strains, it shows that patients have been overseas to acquire them. A few of  patients moving to and fro signify that the patients are vulnerable.

Ray Murakami

While we keep away from such gaffes, we should get the customer to disclose those sufferings

Country in which there are precipitous cliffs with torrents running between, deep natural hollows, confined places, tangled thickets, quagmires and crevasses, should be left with all possible speed and not approached.

While we keep away from such places, we should get the enemy to approach them; while we face them, we should let the enemy have them on his rear.

If in the neighborhood of your camp there should be any hilly country, ponds surrounded by aquatic grass, hollow basins filled with reeds, or woods with thick undergrowth, they must be carefully routed out and searched; for these are places where men in ambush or insidious spies are likely to be lurking.

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:

The translation of this part is reflecting that Sun Tzu did not insist on destroying the enemy but learning about them and possibly convert them to be allies. Thus descriptions about the enemy can be converted into those of the customers.

Translation:

Country in which there are precipitous societal gaps with divides running between, deep historical sorrows, confined views, tangled interests, deprivations and conflicts, should be left unprovoked with all possible dialogues and not offended.

While we keep away from such gaffes, we should get the customer to disclose those sufferings; while we face them, we should let the customer feel supported.

If in the neighborhood of your clinical practice there should be any overcrowded suburb, barracks surrounded by unoccupied businesses, shabby appartments filled with people in needs, or houses with thick mould growth, they must be carefully checked out in examinations; for these are factors where people at risk or insidious health hazards are likely to be residing.

Ray Murakami