Digital Exhaust #209
The death of the cadaver and things we should never measure in healthcare
Here are three things that made me think this week. And an original thought nugget of if you get to the bottom.
The death of the cadaver
Medical schools are abandoning cadavers in education, instead using technology to teach anatomy. Interesting read on why, and what will be lost when medical students are no longer made to uncomfortably face death and learn from a real body. While virtual reality has its place, I think students need to make peace with the imperfect, at times grotesque, nature of their future patients, whether alive or deceased. Another example of how technology, when not carefully applied, can separate us from the real world.
Epic is on X
I never thought I would see this, but Epic (yes, the EHR platform) is now on X, formerly known as Twitter. Colliding with its buttoned-down, corporate persona, the account is riddled with sarcasm and wacky come-backs to questions raised by users. Maybe this is a sign of the apocalypse, or maybe Epic has realized it was time to come out of their strange little hiding place. Check it out. They’re @heyepic.
For fun, they dropped an Epic screen shot from 2001. Didn’t know they had MyChart then….
The narcissism of small differences
In the 1930s anthropologist Gregory Bateson developed the concept of schismogenesis to describe how culture can be based on small differences. Basically, we find small differences and then amplify them to make ourselves different. And it can spiral — Like we’ve seen on social media and cable news. I loved this interesting, quick take from Seth Godin.
The measurable and the unmeasurable (my thought nugget)
Management guru Peter Drucker once wrote, “The balance between the measurable and the non-measurable is a central problem of management.”
It turns out, this is the central challenge in modern healthcare. And we’re not very good at keeping balance.
As we measure disease down to the gene, protein, and biomarker, we are increasingly focusing on what we can count. Metrics are, of course, essential to quality and safety. We want precision in lab diagnosis. We want zero error when sterilizing surgical instruments. And technology does one thing to get us there: It creates efficiencies. Aldous Huxley in Brave New World suggested, “In an age of advanced technology, inefficiency is the sin against the Holy Ghost.”
But not everything in healthcare should be held to a yardstick. The conversation with a woman discovered to be carrying a baby with trisomy 18, for example, can’t be done for efficiency, scale, or speed. The real human work of this critical conversation is nearly impossible to measure. And even if we found a way, it doesn’t mean that it would even matter.
Some things are meant to be done imperfectly and inconsistently. And knowing what not to measure may become one of the most important questions in healthcare.
Leave a comment if you feel moved. And thank you again for opening. Pass this along to someone who might care…like you!
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Thank you for this thought-provoking post! I also enjoyed Seth Godin's post on schismogenesis last week.
Removing humans from the medical experience not only takes the uncomfortable part out of medicine, it makes doctors themselves obsolete. Indeed, companies, including Amazon, have now replaced the doctor-patient relationship with "[health-ish] experts" trained in a particular drug or drug class. It's only a matter of time that all those decisions will be made by AI.
Honestly, I blame doctors themselves. In 2020, when doctors had the most leverage to collectively push back on a false narrative, they chose to become a mouthpiece for the establishment instead. This led to telehealth sessions, and got patients comfortable with remote care. The next logical step is to completely remove them from the equation.
Similarly, journalists stopped doing journalism, also choosing to double down on flawed science and questionable narratives. In January 2025 alone, 500 US journalists were fired. By relinquishing independent thought and analysis, they basically screwed themselves out of a job. Did they not know that a computer could also be taught to say whatever the programmer decides?
As if that's not enough few weeks ago, I went to lunch at a friend's house. She only watches state-run media. She understood virtually nothing about what I was saying, and kept using AI programs in an attempt to refute what I was saying. She NEVER did that in the past. That's the part that gets scary.
What I find interesting is that the medical and scientific communities have missed the most common disease in our society: Carbohydrate Associated Reversible Brain Syndrome or CARB syndrome: https://carbsyndrome.com/deconstructing-the-dual-epidemics-of-obesity-and-common-psychiatric-disorders/