(P)luck: Lessons We Learned for Improving Healthcare and the World – Book Review by Yang Chen

(P)luck is a book written by Blair and Alfred Sadler and chronicles their time working together to shape healthcare policy in the 1960s-70s. As identical twins who carved a ‘medico-legal’ niche, their collaboration has left an indelible mark on areas including organ transplantation, the expansion of the healthcare workforce and the provision of emergency care, with ripples felt across the world. Their book is not merely a recollection of past achievements; it is an embodiment of their dynamic approach – determined, audacious, and respectful, a reflection of the book’s title which evokes spirited determination and an element of luck.

The ethical, moral, political, and economic issues they navigated are of profound relevance today and this book offers a unique interdisciplinary perspective. The value of collaboration across professions is emphasised, serving a reminder of the necessity to adopt a multifaceted approach to address complex problems. The Sadlers’ emphasis on the role of law and bioethics additionally encourages a re-examination of what we may dismiss as intractable problems, urging a ‘think again’ philosophy that is particularly warranted.

The importance of  research and the role of taking risks to solve problems is brought to life with examples such as that of pioneering physician assistant Vivien Thomas. His contribution to surgical practice, although later recognised, remains under-appreciated despite previous calls to name the well-known surgical procedure the ‘Blalock-Thomas-Taussig’ shunt, to honour his role in the work.

Throughout the book, mentorship is highlighted as a recurring enabling factor.

‘Pluck’ is more than a recounting of history and asserts the timelessness of lessons in collaboration and courage. As we grapple with modern enigmas such as Large Language Models and Virtual Reality, ‘Pluck’ serves as a testament to the enduring power of historical wisdom. The book’s closing chapter contains a wealth of curated advice, such as ‘take the road less travelled’, exemplified by Don Berwick’s transition from paediatrics to founding the Institute for Healthcare Improvement. ‘Dwell in possibility’ highlights to readers the value of adopting a ‘possibility perspective’ as a mindset which is pivotal for change.

In summary, ‘Pluck’ is not just a retelling of healthcare’s past triumphs; it is an essential read for current and aspiring healthcare leaders to stay the course and forge ahead with wisdom, courage, and an open mind.

Book Reviewer

Yang Chen

Yang began working as a medical doctor in London in 2013 and started his Cardiology specialty training in 2017. He was appointed as a Founding Associate Fellow of FMLM in 2018 and has helped medical students and junior doctors across the country through the FMLM Mentoring scheme. Yang has also been Chief Registrar at St Bartholomew’s hospital (2020-21). He is currently a clinical research fellow and PhD candidate at UCL, where he works to embed pragmatic clinical trials of digital tools within electronic health records. He enjoys listening to podcasts and reading books related to digital technologies, decision-making and healthcare leadership.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.

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