Outsiders tend to be the first to recognize the inadequacies of our social institutions. But, precisely because they are outsiders, they are usually in a poor position to fix them.
Interpretation
Outsiders see the flaws in our institutions, but their lack of integration limits their ability to improve them.
This quote highlights the paradox of outsiders in society; while they may be able to identify the shortcomings and inefficiencies of social institutions, their outsider status often prevents them from effectively enacting change. Their distance from the established system makes it difficult for them to understand the complexities and nuances required for meaningful reform.
In practice
In a discussion on social reform, one might quote Gawande to highlight the importance of insider perspectives.
A failure often does not have to be a failure at all. However, you have to be ready for it-will you admit when things go wrong? Will you take steps to set them right?-because the difference between triumph and defeat, you'll find, isn't about willingness to take risks. It's about mastery of rescue.
No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.
Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.
When I do an operation, it's half a dozen people. When it goes beautifully, it's like a symphony, with everybody playing their part.
At times, in medicine, you feel you are inside a colossal and impossibly complex machine whose gears will turn for you only according to their own arbitrary rhythm. The notion that human caring, the effort to do better for people, might make a difference can seem hopelessly naive. But it isn't.
We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.
The subway in New York is a great social experiment; there are so many races and ways of life sitting together on each car.
It goes without saying that the Jewish people can have no other goal than Palestine and that, whatever the fate of the proposition may be, our attitude toward the land of our fathers is and shall remain unchangeable
A lawyer with his briefcase can steal more than a hundred men with guns.
I hate it because of the monstrous injustice of slavery itself. I hate it because it deprives our republican example of its just influence in the world.
The individual's desire to dominate his environment is not a desirable trait in a society which every day grows more and more confining.
I want to put on the table, not why 85% of the members of the National Academy of Sciences reject God, I want to know why 15% of the National Academy donβt.
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