Life Update

A patient arrives.

Sometimes to the clinic, to be diagnosed and treated.

Sometimes to the emergency department, with something dangerous.

Sometimes the patient is already on the table, asleep, and the first cut is mine to make.

Every one of those moments requires knowledge.

Anatomy. Physiology. Pathology.

The technique. The potential complications.

Good surgeons read the literature all the time. Great surgeons also learn it from each other.

But what's it like when you're a resident?

When you're training to become a surgeon?

As a resident, you're supposed to walk into the surgery prepared.

When you don't have much time to prepare, you need to find the relevant paper quickly.

With enough repetition, the literature stops being something you look up, and it becomes something you HAVE.

It LIVES in you.

Lately, I hand over less.

I stand at the table, ready to give up the blade. 😷

That's how the next surgeon gets made.

But how do I know I can hand it over?

I go looking for the knowledge. The reasoning. The why-this-and-not-that.

I ask questions.

More and more, the knowledge isn't there.

So the scalpel stays in my hand.

Number 163!

Observing the Great

I know exactly how this sounds.

"The young ones don't read anymore."

Every doctor my age says it. Every doctor before me said it about MY generation. It's the most tired line in medicine.

So let me earn the right to say it.

There's a quote I keep returning to: "observing the great opens your mind to fresh possibilities." (It's from the book Decoding Greatness, see the "Stuff" section below).

In other words, the best in any field don't start from ground zero. They study the great works of others. They read books.

Which is exactly what books are for.

🔵 A Person, Flattened Onto Paper

Do you know how many true masters you will witness in your career?  I'm talking about the ones you actually stand beside, whose hands you watch until the movements become yours.

One. Two if you're lucky.

Everyone else who shaped you, you meet ON PAPER.

That's what a book really is - a person, compressed.

A manuscript was the first tool humanity ever built for standing next to greatness you'd never get to meet.

Someone spent thirty years learning a thing and printed it on paper so a stranger could absorb it in a week.

So you never just read. You are being taught by someone who can't be in the room.

🔵 When You Could Read It All

But here's the problem.

When I was a resident, there were mostly books and a few journals.

I could read EVERYTHING. Every issue, cover to cover, with time to spare. Reading wasn't a discipline you had to force. It was simply possible.

That's not the case anymore.

There are too many journals now, too many manuscripts.

And it's not that the literature got richer and better. It got drowned. There's simply too much of it.

So it became impossible to keep up with it.

And then it became even worse…

Because then came AI.

🔵 Ten Hours With a Machine

I watch it happen.

I ask a question that should send a resident to the books.

But instead, I get a minimal Google search.

Or a quick AI answer.

Little pieces of information that don't connect to anything and don't stay in the mind.

Not because anyone is lazy. (At least, I hope not.)

Because the thing that made me knowledgeable was taken off the table.

Don't get me wrong.

I use AI a lot.

Probably more than anyone I know.

I love it.

I can sit with it for ten hours straight.

Not for a single quick answer. No no.

I want the deep dive into the data.

To push through 100,000s of rows in a spreadsheet. To ask it the questions I can't answer alone. Argue with it until something gives. It is one of the best thinking partners I've ever had.

But it hands you exactly what you BRING to it.

Bring a mind built by years of reading, and it's a superpower.

Bring a mind that only ever wants the bottom line, and it gives you the bottom line.

Same tool. Opposite result. The difference is entirely what was already in YOU before you opened IT.

And that's the quiet cost. The chain gets broken.

When the reading link goes, you won't receive the scalpel.

You can't hand a blade to knowledge that isn't there.

So it stays in my hand.

For now.

Book I Read

📚 Book I Read — Decoding Greatness by Ron Friedman.

Greatness isn't copied or invented from scratch. It's reverse-engineered.

You collect work you admire, take it apart, and learn the structure underneath.

It reads almost like a manual for how humans used to learn before we started asking machines for the summary. Worth it, and short enough to actually finish.

Epilogue

That's it for this issue.

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See you next week!

Shay