Skill, surgeons believe, can be taught; tenacity cannot. - Atul Gawande

sometime over the last several decades — and it is only over the last several decades — science has filled in enough knowledge to make ineptitude as much our struggle as ignorance.

The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can’t, someone who understands that the damage is greatest if all you do is battle to the bitter end.

The battle of being mortal is the battle to maintain the integrity of one's life-to avoid becoming so diminished or dissipated or subjugated that who you are becomes disconnected from who you were or who you want to be.