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Handovers and Debussy
  1. D P Stevens
  1. Dr D P Stevens, Adjunct Professor and Director, Quality Literature Program, Dartmouth Institute for Health Policy and Clinical Care, 30 Lafayette Street, Lebanon, NH 03766 USA; David.P.Stevens{at}Dartmouth.Edu

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When I started to study the piano at the age of eight, I would labour over my exercises and pieces, one note at a time. As I learned to read music, there was always a sense of accomplishment when the played notes seemed to reflect correctly the musical score in front of me. I don’t recall anyone ever calling me a musician, certainly not my first teacher. Getting the individual notes right and in correct sequence was a long way from making music. For me it was all about the notes. Claude Debussy is said to have clarified this issue that generally eludes most novice musicians, when he said, “Music is not just about the notes. Rather it is created by the spaces between the notes.”

Healthcare steadily becomes more complex—more chronically ill people who live longer, and sicker patients who require more powerful medicines and riskier procedures. Randomised controlled trials indicate the drugs and procedures that work best for many diseases. Junior doctors (resident trainees) learn these parts quickly and effectively. As important as this knowledge is, there is increasing recognition that the value …

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