numero rivista e pagine: HSR Proceedings in Intensive Care and Cardiovascular Anesthesia 2012; 4(2): 133-134
PDF version

Because good enough is never good enough

Authors: M. John*

Head of Medical Humanities International MD Program, Professor of Biomedical Communication Skills, Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy

Corresponding author: * Corresponding author:
Prof. Michael John
UniversitÓ Vita-Salute San Raffaele
Via Olgettina, 48 - 20132 Milan, Italy
E-mail: michael.john@hsr.it

Well it isn’t, is it? Imagine yourself as a patient. You are, first and foremost, not at all happy about having to see a doctor about this worrying problem that has been disturbing you for rather too long. You are sitting in the waiting room, thinking. You are still sitting in the waiting room, thinking, more than half an hour after your scheduled appointment time has come and gone.
The doctor is late, as can happen, of course, especially in busy hospital environments. The problem is that when he eventually does get there, not only does he seem to totally ignore the extra 30 minutes that you have been obliged to suffer, but even adds insult to injury during the interview and the physical examination.
He never explains what he is doing during the physical, and tends to be rather too judgmental in his attitude. Shouldn’t medicine be a caring profession, where doctors at least try to empathize with patients when they are at their most vulnerable and in need of understanding? You get the impression that you are simply a pathology, and not a person that is worried, and maybe even terrified, about his future well-being. In your opinion, in the patient’s opinion, this is just not good enough.
And now for something completely different. Formula one racing drivers need to know the track they will be speeding around to avoid injuring themselves and others, and hopefully to win the race they will be taking part in. I have heard stories of certain scrupulous drivers that drive around the track on a scooter on the days before the race, so that they might get a closer look at the cracks and bumps in the track. Is this good enough? Possibly.
Legend has it that the great Ayrton Senna would avoid scooters altogether, and would walk around the race track, feeling the eventual cracks and bumps through the soles of his shoes. In my humble opinion, this is more than good enough! But, there again, Senna was arguably the greatest driver of all time, or at least he really was a top-level professional.
The world of peer-to-peer communication is full of examples that show us how good enough is never quite good enough. Failing to follow a journal’s Instructions to Authors, for example, is not only dangerous, but has also to be considered rather silly. I recently came across a paper that risks rejection, or, at the very least, delayed publication as the graphic elements do not correspond to the appropriate legends. Not good enough.
In another paper, evidently a ‘team effort’ as far as writing is concerned, there is excessive repetition and a great deal of redundancy. Not good enough. Furthermore, the writing style of the separate sections is planets apart, making it evident to any reader that no serious editing has been carried out. Once again, not good enough.
Endless examples, unfortunately, exist.
What about when you find commas - 55,25 - instead of decimal points - 55.25 - in tables? What about when there is no agreement between subjects and verbs (our data is well-documented should be our data are well documented) or adjectives and subjects (little data are available on the matter should be few data are available on the matter). Too pedantic? Although in many contexts nowadays data is considered a singular noun like news and information, in the biomedical field we virtually always use data as a plural, and therefore with a plural quantifier and a plural form of the verb.
Hands up if you have never seen a poster that is full of minute writing, together with one or two poor quality images, all thrown haphazardly onto some kind of psychedelic, where blue will undoubtedly be present, background.
How many times have you seen presentations at congresses where the speaker himself (or herself, naturally) seems to be more interested in the coffee break than the audience that unfortunately has to sit through this disaster, pending said coffee break? 
Remember. None of this is good enough, and never will be good enough.


'This is the fourteenth of a series of articles on this topic. Send any questions to michael.john@hsr.it who will answer them as part of this column'