Last night was a little more extreme in Casa Pukeko than usual. I have a meeting this afternoon on debriefing policy for the hospital I’m affiliated and had a 8 cm stack of paper to read. At the same time my son was trying to analyze a timed series of ozone measurements. Three of them. He tells me this morning that he finally got to sleep at 2 AM. While inhaling breakfast.
How does this relate to what the passage of today is? Well, single episode debriefing does not work. Neither does multiple episode debriefing. We have rigourous meta analyses in the Cochrane collaboration about that. The second one dealt with tissues from the first. But debriefing has become a civil religion and HR (plus a number of senior nurses) firmly believe it should remain in place. I’m going to argue that this is not necessary, and we can (ahem) use the money to do things that may be more effective. Like, perhaps. treat people, which is what we should be about. But in doing this I am offending that secular God, the American Red Cross, who own and promote debriefing.
Jeremiah 10:11-24
11Thus shall you say to them: The gods who did not make the heavens and the earth shall perish from the earth and from under the heavens.
12 It is he who made the earth by his power, who established the world by his wisdom, and by his understanding stretched out the heavens.
13 When he utters his voice, there is a tumult of waters in the heavens, and he makes the mist rise from the ends of the earth. He makes lightnings for the rain, and he brings out the wind from his storehouses.
14 Everyone is stupid and without knowledge; goldsmiths are all put to shame by their idols; for their images are false, and there is no breath in them.
15 They are worthless, a work of delusion; at the time of their punishment they shall perish.
16 Not like these is the LORD, the portion of Jacob, for he is the one who formed all things, and Israel is the tribe of his inheritance; the LORD of hosts is his name.
17 Gather up your bundle from the ground, O you who live under siege!
18 For thus says the LORD: I am going to sling out the inhabitants of the land
at this time, and I will bring distress on them, so that they shall feel it.
19 Woe is me because of my hurt! My wound is severe. But I said, “Truly this is my punishment, and I must bear it.”
20 My tent is destroyed, and all my cords are broken; my children have gone from me,
and they are no more; there is no one to spread my tent again, and to set up my curtains.
21 For the shepherds are stupid, and do not inquire of the LORD; therefore they have not prospered, and all their flock is scattered.
22 Hear, a noise! Listen, it is coming — a great commotion from the land of the north to make the cities of Judah a desolation, lair of jackals.
23 I know, O LORD, that the way of human beings is not in their control, that mortals as they walk cannot direct their steps.
24 Correct me, O LORD, but in just measure; not in your anger, or you will bring me to nothing.
What can we take from this passage?
Firstly, that which is false will perish from this earth. The ideologies that are ineffective. The therapies that become quasi religions but have no data to indicate that they work. (One of the signs of this s long criticisms of the research that is done, that is not perfect, not understanding that any work done — and I have just completed an open label trial about preventing violence in health care workers — has difficulties in the field and is not done perfectly. But when you have three or four papers showing no effect or worsening effect, it is time not to blame the researchers bur review what you are doing).
Secondly, those who point this out will not be popular. Our leaders are quite foolish: they neither look to the Almighty nor do they consider the evidence that is there — because it either offends their ideology or punctures their narcissism. I am not looking forward to this afternoon. I may end up i from this process and resigning from the committee if it advocates positions that are ineffective or harmful.
Thirdly, we cannot rely on having helpmeets or support. They can be taken away from us. The current family court structure is good at that — but so is disease and death. Those whom we love may not be there when the pressure goes on.
Finally, God is just. We have to stand: we do not need to get justice. God will give justice in the end, and it will be terrible. For all those comforting lies that we idolize will, like the ancient pantheon, perish from this world.
