Applying The Art of War in The Battle for Patient Safety

Chew, Keng Sheng (2024) Applying The Art of War in The Battle for Patient Safety. UNIMAS Publisher, Kota Samarahan, Sarawak. ISBN 9789670054506

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Sun Tzu’s Art of War is perhaps one of the most popular ancient military treatise that has been accepted, translated, studied and applied in various non-military fields such as in management and business administration, politics, economics, sports, etc. Historically, the Art of War (Sun Zi Bing Fa 孫子兵法) was written approximately 2,500 years ago (512 BC) but it did not reach the West until 1772, when the text was translated into French by a French Jesuit called Father Jean Joseph Marie Amiot who had spent many years in Beijing. The first English translation of this treatise came almost two centuries later by Captain E.F. Calthrop, a British army language student in Japan in 1905. Embedded within its Taoistic philosophy and the yin-yang principle, the Art of War contains many apparent paradoxes. These paradoxes, however, do not imply incompatibility in the way we understand the law of non-contradiction, where a premise cannot be both p and non-p at the same time and in the same sense. As aptly described by Yuen (2008): “It is impossible to understand how the Chinese dialectical system works without first recognizing that there is not necessarily any incompatibility in the Chinese intellectual tradition between the belief that A is the case and the belief that not-A is the case. On the contrary, in the spirit of the Tao or yin–yang principle, A can actually imply that not-A is also the case, or at any rate that it will soon be the case. In other words, the law of identity, which holds that a thing is itself and not some other thing, and the law of non-contradiction, which holds that a proposition cannot be both true and false, do not always apply in Chinese thought. Far from being two irreducible or even mutually exclusive states, yin and yang (or A and not-A) are two consecutive stages that are produced by the deployment of reality.” Sun Tzu stressed on the importance of winning the war by employing the right strategies at the right time for the right kind of war. In fact, a lot of emphasis was placed on the strategy of winning by subduing the enemy without fighting as Sun Tzu knew that war is always a costly affair and can deplete a state’s resources (Lee et al, 1998; Yuen 2008). The art of winning the war without actually going to war is a classic example of the apparent paradox where p and non-p can appear at the same time and in the same sense. But, like it or not, wars are inevitable. After all, as Sun Tzu himself alluded to, in the very first two verses of Chapter 1 of The Art of War:“The art of war is of vital importance to the State. It is a matter of life and death, a road either to safety or to ruin. Hence it is a subject of inquiry which can on no account be neglected.” Similar to the days of Sun Tzu, working in an emergency department is like going to a battle. However, there are just too many “wars” that one must battle for. Therefore, the question is not whether one should engage in any kind of war because wars are inevitable. The question is, what kind of war should one choose to engage in? The key is to prioritize and to choose the war that needs to be tackled while ignoring those wars that do not bring benefit. One of these important battles that a clinician must engage in is the battle to maintain patient safety. I first got fascinated with The Art of War when I read of the wisdom contains in this classic ancient text and how it has been applied in various fields. Nonetheless, I also realize that there is a paucity of literature on its application in the clinical context. A cursory Google search shows that apart from a few scanty papers and one blog post published by an emergency physician, Dr. Richard Carden in a website known as “St. Emlyn’s” (a word coined for a fictitious emergency care system), there is no other references on its application in the clinical context. Even then, the amount of information that I could learn from these few papers are very limited. Nonetheless, being an emergency physician, I agree with Dr. Richard Carden that in order to have a wider application of The Art of War in the clinical context, the “enemy” as described in the ancient text should not be myopically construed to mean a single arch nemesis. To quote Carden in his introduction on defining the “enemy”: In emergency medicine we have many ‘enemies’. I use this term as a metaphor, and I would invite you to see the term ‘enemy’ as a metaphor for a challenge rather than an arch nemesis. Our enemies/challenges are numerous; 4-hour targets; increasing age of the population; increasing demand on the NHS [National Health Service]; bed-blocking; repeat attenders…. the list seems endless.” In fact, I would add that the “worst enemy” could even be our own selves (see Chapter 1). As Commandant Oliver Perry poignantly once said: “I am my greatest enemy!” As we shall see in this book, Sun Tzu, indeed, had a lot to say on this point based on his oft-quoted saying ““If you know the enemy and know yourself, you need not fear the result of a hundred battles”. At this juncture, an important disclaimer must be made. Although I am fascinated with the Art of War, I am not a literature expert in this classic text. I cannot exegete the text in its truest and purest form within its original socio-cultural context, let alone doing so in its original Chinese language. I can only apply the principles that I found interesting and relevant in clinical setting and in patient safety. The English language translation of The Art of War used in this book is mainly the translation by Lionel Giles in 1910, now available freely in public domain. The divisions of chapters and verses applied in this book are also taken from Giles’ translation. Readers of this book are encouraged to read it together with Giles’ translation text that can be freely accessed and downloaded (in pdf and text formats) from this website Occasionally, I had also quoted from the translation by Michaelson (2001) due to the clarity of this translation in the modern context. I hope that this book will continue to be a valuable addition for many years to come to the rich body of literature on the modern applications of the concepts and philosophies of Sun Tzu’s Art of War, particularly in the context of clinical medicine.

Item Type: Book
Uncontrolled Keywords: Art of War, The Battle, healthcare services, patient safety.
Subjects: B Philosophy. Psychology. Religion > B Philosophy (General)
R Medicine > R Medicine (General)
U Military Science > U Military Science (General)
Divisions: Academic Faculties, Institutes and Centres > Faculty of Medicine and Health Sciences
Faculties, Institutes, Centres > Faculty of Medicine and Health Sciences
Depositing User: Sheng
Date Deposited: 16 Apr 2024 02:12
Last Modified: 21 May 2024 07:32

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