Wednesday, February 8, 2017

Repair and monitoring

I have read several books by Atul Gawande.  He is an American surgeon and author. He is on the faculty at Harvard.  When I see an article by him, usually in the New Yorker, I read it.  I just read "Tell Me Where It Hurts" by Gawande in the Jan. 23, 2017 issue.  

He reviews US highway maintenance, citing a bridge collapse in 1967, and explains the dawning recognition that bridges needed to be inspected for fatigue and repair or replacement needs.  The bridge was 40 years old and its aging could have been detected over time but wasn't.  Not only time and deterioration steadily affected the bridge but there was also a steady change in the type of traffic that traveled over it.  Heavier vehicles and higher speeds came into use.

Gawande is the son of two Indian physicians who moved to the US years ago.

The "Tell Me Where It Hurts" article contrasts the heroic, dramatic sort of medical practice with the slow, steady monitoring and small corrections that are more possible today.  Of course, it is rather human nature to remember the dramatic and overlook the quiet but some things can be accomplished gently and steadily that don't lend themselves to a dramatic treatment.  Just as quiet changes took place in American traffic, new knowledge and new inventions such as a slew of apps and technology now make possible monitoring of our fundamental health variables.

Because of our commercial approach of marketing and advertising, it is easy to tout the new and call anything older "obsolete".  I have been told by technologists and those in the history of technology that no technology ever totally disappears.  We still have archers and blacksmiths, just fewer of them and less demand for their skills and activities.  We are finding that we can't pay attention to everything, probably not even to everything that is important and matters.  But from time to time, we will no doubt change what we observe and what we emphasize.

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