eHealth – The Reality Show Sequel

Let’s think more about life, taking an unusual break from our everyday professional reality. So much of what we do distracts us from what and who we are. First,   we  are humans, individuals with hopes anddreams, drives and impairments and the need for rest and comforting reflection on what we accomplish. Unfortunately, the intensity of the environment in which we work and the limitations of time, energy and opportunity don’t always provide time for reflection.

Here are a few more of the things we face in our lives. Although we may avoid some, we won’t avoid them all and what we do with each one will make us who we are.

We will have to make great efforts.

It is always amazing how much effort even simple things can take. However, when facing the complex challenges of human health and health care, at times the effort approaches the super-human. Pretty well everyone recognizes that we invest large amounts of sweat in whatever equity we achieve. Sometimes that effort involves exhausting days and sleepless nights. Sometimes it involves putting aside satisfaction in order to get real traction. Sometimes that effort comes close to sucking the life out of us; sometimes that effort goes beyond what we are able or willing to make. All one can count on in life is that almost everything of value will require what can be mind-numbing effort. Of course, there are a few for whom things are easy, or so it seems. What that usually means is that they make their efforts behind the scenes. We are all cursed with the burden of trying to make a difference, but blessed both with the opportunity to try and, at least sometimes, to succeed. Big message from the sages: we must recognize it will be hard, that we can’t can’t change the channel, and that there is no magic key you can get from the Web. Effort, sometimes extreme effort, and the discipline to make it is essential to achievement!

We will learn that listening is more powerful than talking.

Listening is difficult, especially when we want someone to know that we are listening. This can be because we are distracted by a thousand other things, or just don’t have the patience or forbearance to listen. Listening means the opportunity to comprehend, to understand what another human needs. We may try to listen, but unless the speaker perceives it, our listening (and our impact on the person) will be less effective. I had to learn a lot about active listening (and still do) because I often don’t look like I am listening and perception is reality. Also, we tend to be thinkers and problem solvers rather than comprehenders and empathizers. Health Informatics has, as its most primitive action, the understanding of, in all its depth and technicolor complexity, the nature of human health and the health system. Listening is one of the key skills that we need in order to carry out this function. How many times do we listen to someone else and then immediately proffer our advice – sometimes truncating the listening process?

According to research, physicians do this a lot, interrupting patients before they’ve told their complete stories. When dealing with other people, a major part of the impact we have is the listening process. And I don’t mean being able to repeat back the last 10 words, a trick we learn from dealing with our spouses! We need real listening! Listening that puts down what we were doing before, puts aside the distractions, shuts off the smart phone and enters a shared state of consciousness with another human. Honing one’s listening skills is one of the most important, long-term and personally challenging disciplines we must perfect.

We will realize that the team is the unit of success.

Yes, as individuals we must make personal sacrifices and efforts. But, the challenges we face can only be addressed by a team comprising adequate knowledge, skills, experience and attitudes. NIHI teaches courses in the basics of Health Informatics. Those courses make those who wish to enter our field aware of virtually all the aspects of the field, albeit it shallowly. However, no one person can master more than a small number of these. Our objectives are to have people recognize that there are many components to successful approaches to eHealth challenges and to have them see how to build the team that has the panoply of abilities needed. In terms of leadership, we want all team members to lead within their areas of capability and for the rest of the team to take advantage of that leadership. There is an interesting program called ‘Teams of Leaders’, originating with the U.S. military, and provided in Canada by Professor Candace Gibson at Western. My own understanding of the concept of team came from when I studied it from the vantage point of the military team. This is the kind of team where not only achieving the objective, but also each team member’s life depends on the others on the team – where everything is at stake and oblivion is the price of failure.

We will need mentors.

Much of mathematics is done by individuals, far less of physics is like that  and  little  in  Health Informatics  and eHealth is that way.  Mentors give an alternate perspective, guidance, advice, warnings, and assessments of what is important and what is not. It is probably also true that different mentors will be needed at different times and for different situations. Mentors are helping hands with vision that goes beyond our own. They look beyond the trees to see the woods and get us outside ourselves so our own biases and foibles don’t blind us. Finding mentors is challenging, as some are selfish with their time. However, they are out there. We need to ask around, find those with whom we can relate and get a boost from them. Maybe thinking of ourselves and our mentors  as our personal team works. One of my greatest regrets was that I passed up the possibility of having an incredible mentor when Prof. Carl Anderson reached out to me. I demurred, as I was having an extremely bad time as an undergraduate in Physics at that moment. He had gotten the Nobel Prize for discovering the positron. Imagine what difference that could have made for my career.

We will recognize that originality is rare (and precious).

I often tell people: “We are ants”! What I mean by this is that there is a high degree of similarity among people. Things we take as private, embarrassing, unique and intimate are shared with millions  or even billions of others. Sure, we all have aspects that are unique, we each give things a different color, and we bring a certain freshness with us. But, the similarities among us are pervasive. This comes up in our work when we think we have a great idea. The Web is the new equalizer (it used to be a six- gun) where we can quickly discover that our ‘innovative’ idea already has 1,000 articles and five books, two courses and six online lectures about it. Being truly innovative is very challenging as most people who have worked in startups can tell you. What this means is that, as we spawn ‘new’ concepts or things, we need to do research, have the humility to look around us to see what already exists…and maybe go along with that instead of just trying to be original.

This is not to say that some aspect of what we might think or do isn’t new  on this planet. Sometimes what we come up with is a differentiating aspect that is a major contribution. It is to say that, if we dare look down, we will see that we stand on the shoulders of our predecessors and, in many instances, of our contemporaries. You can even look at Nobel prizes to see this. How many are awarded to people who didn’t know each other and/or didn’t know of each other’s work, but who made the same or a closely related contribution. I’m thinking particularly of Sin-Itiro Tomonaga (in Japan during WW 2) and Richard Feynman together with Julian Schwinger in the U.S. for their work in Quantum Electrodynamics.

We need quality life partners.

Okay, some people can live entirely solo and are not needy of others. For   most of us, though, our life partners are the secret ingredient, if not related to whom and what we are, then related to how happy we are. I have been very fortunate. I had a life with my wife for over 40 years. I cannot tell you how much I learned from her about medicine, about people, about everyday existence, and about myself. Finding the right partner, and, admittedly, one may do this more than once, is a life-crucial activity for most of us. Think of all the topics in these two articles. Pretty much all of them apply equally well to the human partnerships we form. Those partnerships provide the opportunity to talk things out, to learn how to listen, to get advice – even mentoring – and to have a team to sustain oneself through the effort life requires. This one probably doesn’t need to be sold, but I hope we all recognize its importance and its contribution to our development, our humility and our self-esteem.


There many other assertions in this meandering through the life-aspects of a professional. Perhaps we can list a few without the explanations. Consider these:

  • Reputation trumps ego. No matter how great you feel you are, it’s what you’ve done and others’ recognition of that that is crucial.
  • The hardest thing to get over is yourself. It is often our own natures that undermine our becoming and acting better.
  • Heroism is easier than cowardice. The hero dies once, while the coward dies 1,000 deaths. Undertaking the discipline of day- to-day heroism (like becoming fit, enduring therapy, keeping a family together, living with teenagers, or just getting up some mornings), builds character.
  • Nothing is ever complete. Knowing when enough has been done is the height of good judgment. I guess another adage is fit: “Perfection is the enemy of the good”.

This brings an end to this series of thoughts. Maybe you can add   some that are important to you and someday we can put those together in another missive. My hope is that these thoughts have simulated yours and that your focus will shift now and then to yourself and your life and not just on the intricacies of computing, health care and management.

Perhaps my final words should be the same ones I used to initiate this series: Let’s think about ourselves and life.

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