All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.
He picked up an Amazon Kindle e-reader and tried to make the text scroll by touching the screen. He was puzzled when it didn't work. We discovered that this model had button controls. That is so 5 minutes ago!
He's used to touch-screens through playing with his brother's iPod Touch and Grandma's iPad, so he's come to expect that every electronic device works that way. It's like the classic scene in Star Trek IV, when the crew goes back in time and Scotty tries to use an early-model computer:
As Schopenhauer predicted, Scotty is ridiculed for having expectations (his "truth") beyond what was thought possible in that era.
Last week, at the IHI National Forum, I had my expectations raised by someone else's truth.
Jason Leitch, NHS Scotland's National Clinical Lead for Quality, gave an energetic presentation about Scotland's healthcare quality strategy and results. One slide stood out. It showed the drop in central line infection rates since 2008. The March 2011 data point was annotated "zero central line infections in whole country".
Entire country of Scotland. Central line infections. None.
It's like getting rid of polio or smallpox.
I was imagining what it must be like to be a physician inserting a central line, or a nurse caring for one, in Scotland. The motivation to follow standardized protocol meticulously must be tremendous. The country's reputation is on the line! Expectations are sky-high.
What if patients and families in other countries found out that central line infections can be avoided? If they got hold of Scotland's data and the care bundle they use, expectations everywhere would be sky-high. Then, after the ridicule and opposition (from healthcare professionals), it would become self-evident that these infections are a defect in care, and not inevitable.
Central line infections - how quaint!