Crisis! Crisis! Crisis?

Imagine this scenario: you approach a patient and tell them that they have a terrible brain disease. It is too complicated to explain to them, but they need to let you decide what to do with their life since you are the expert. You must act now because there is no time for discussion.

What would you do in the same position? What do you think that a patient would do? I would suspect that most people would not give their life and life decisions to a doctor without some explanation or choice on their part.

Now 3 weeks later you go back to the family and say that you made the wrong choice and that you need to do something else. The family has already given you the right to make all the decisions. Now what would you think?

The family would not be too happy that they gave away the right to make their decisions and would have lost faith in you as the doctor.

Basically what the family is being told is that they are unable to understand any explanation, that only certain intelligent people can understand things of this nature, so it is impossible for the average person to understand these things.

This fear and crisis production is a politician's way of gaining control of your life. That is what socialism is and does. Remember “Animal Farm”: “All pigs are equal, but some are more equal than others.” (Some are smarter than others, for example, or deserve to make decisions more than others who are believed to be too stupid to understand what is necessary.) Orwell's famous lines, from his book published in 1945, were written as a protest against communism. Well, what he characterizes as, the “more equal animals” in his book, I interpret to be the politicians who do not think you are smart enough to make your own decisions. You could never get away with this thinking in medicine, nor would you want to.

Now, does this scenario really happen? In medicine, I would seriously doubt that such a thing could happen, but we are now facing just the same decisions being forced upon us by our politicians as citizens in many countries of the world. The economy is in a crisis! we are told. Something needs to be done immediately or there will be a disaster, we are told. It is too complicated to explain, they imply but in reality the economists do not know what to do either. Alan Greenspan, the former head of the United States Federal Reserve, was shocked by the collapse of the world markets. He could never have imagined such a catastrophe, he said. Former US Secretary of the Treasury Henry Paulson changed his crisis plan 3 weeks after he instituted it and said his initial plan was wrong. By shocking and frightening everyone to believe a crisis exists, the politicians gain control over the average citizen's decisions. The politicians created the mortgage crisis in the first place via legislation that allowed people with poor credit to buy homes and get mortgages. Moreover, some banks were permitted to become large investment companies that had fewer restrictions than the banks once did which allowed them to make more risky transactions. Their greed to make more money was fueled by the lack of regulatory supervision of the banking and investment communities. Now all over the world, we are giving public money to those who made the mistakes instead of the citizens, who should know what they want to do with their own money better than the politicians.

But remember, we are unable to understand these complicated issues, so this criticism is rejected as being stupid!

Why is this analogy important to physicians and neurosurgeons? Because at the end of this crisis-way-of-thinking is a worldwide health care system that is also being defined as in a crisis. Major changes need to be made immediately, we are told. It is too complicated to explain but we need to give our politicians the control over our health care decisions, we are told. This situation has already occurred in many countries in the world and is now coming to the United States.

There is an old tale about a person who cries “Wolf! Wolf! Wolf!” too often. Eventually, no one believes him. In medicine it is very rare that we need to make crisis decisions—certainly not until we have some facts and can understand what is happening. Yes, we can make rapid decisions, but there is always time to think and develop a plan.

Remember what you have learned to do everyday both in the operating room and hospital is how you think and how you make decisions in all aspects of your life. This thinking process that has taken you years to develop should not be discarded just because someone else says so. You need to proceed with every other decision as you do clinically. This includes family, hospital, business and political decisions. Otherwise, mistakes will be made. And you will lose control of the decision process. You have developed a reasoning process that is excellent; do not discard it. It works in all situations, crisis or not.