There is a sentence I keep coming back to from last week’s essay.
The patient does not care whether our hard is scientific, operational, commercial or political.
It is the simplest line in the piece. It is also the one that organises everything else.
We spend a lot of time in IBD arguing about which hard matters. Mechanism versus implementation. Trials versus real world. Drug development versus delivery. Basic science versus clinical service. The arguments have merit. They are also, often, a kind of professional comfort. Each camp gets to feel that their hard is the real one.
The patient is not in those arguments.
They are in clinic, with fistulas that will not close, or fatigue no one can explain, or a flare that has arrived three weeks before a wedding. They are watching their twenties narrow before they have really begun. They are doing the maths on whether to start a family.
They do not care whether the answer comes from a biologist, a data scientist, a policymaker or a pharma company.
They care whether it comes.
And whether it comes in time.
That is the test that ultimately matters. Not the elegance of the science. Not the citation count of the paper. Not the shape of the funding stream. Those things may matter inside the system. They are not the measure the patient lives by.
The measure is simpler, and harder.
Did the person in front of you have a better year than the last one?
If yes, you were working on the right hard.
If no, we should be honest enough to ask whether we chose the wrong one, or pursued the right one too slowly and too far from the patient.
That is what I mean by our hard: not the work that lets us sound serious to one another, but the work that leaves the patient with a better year than the last one.
That is the work.
Read the full essay here: “This is Our Hard”
Thank you for this!! I hope other IBD consultants take this to heart.
Great