Nonlinear Dynamics and Navigating the End of Life

摘要

As a family physician who migrated to the practice of palliative medicine, I’ve spent the past 20 years pondering the rules American medical culture observes regarding the way people die, and the role of physicians in that final transition. Culture is a nonlinear system where the tension between creatively adapting to unexpected challenges and coping with the tedious boredom of mechanistic certainty are delicately balanced. Add more control and the system becomes stultifyingly rigid, while less restraint can send the system spinning into anarchy and chaos. Small perturbations can have dramatic consequences, and slight modification of the rules can determine whether the system flourishes or decays.