Not everything that counts can be counted; not everything that can be counted counts
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7432.153 (Published 15 January 2004) Cite this as: BMJ 2004;328:153
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Einstein had another famous oneliner that may be applicable to Prof
McKee’s commentary, “make everything as simple as possible, but not
simpler”. With regards to putting up tents in no-man’s land in order to
meet emergency department waiting time targets, that other bon mots of his
springs to mind “Only two things are infinite, the universe and human
stupidity, and I'm not sure about the former”
Competing interests:
None declared
Competing interests: No competing interests
Having retired and moved away from the area in which I worked I have
become an increasing user of the NHS, and find it impossible to get
worthwhile information on which to make a balanced judgement about things
which should be easily counted. The informal local knowledge that was
available and useful is no longer available to me. My general
practitioner who is excellent only knows the local services, and does not
know what their results are. I needed a hernia repair - but surgical
results are not available. Local anaesthesia and day case surgery as
your editorial recommends - no information available, and in particular no
warning that the surgeon has an unrealistic belief in the rapidity of
onset of action of local anaesthetic. Need another hip replacement? No
information about results to help with the decision whether to travel back
to London, or have surgery locally.
If we take seriously public
involvement in health care, and if we believe in using industrial
processess in health care on which the same issues carries articles this
is not good enough. I have to disagree with Einstein and McKee - these
things can and ought to be counted, and they do count.
Martin McNicol
Competing interests:
Active NHS service user
Competing interests: No competing interests
Counting (in vain) on Correct Attribution
Martin McKee and Philippe Beutels recommend with enthusiasm witty
aphorisms which they attribute to one of the greatest thinkers of our
time, Albert Einstein. The message is clear: pay attention, because this
comes from someone who really knows! Alas, it isn’t so. The sign which Dr.
McKee says Einstein hung on his wall, “Not everything that counts can be
counted; not everything that can be counted counts” likely never existed.
Similarly, Dr. Beutels’ crediting of Einstein for “Make everything as
simple as possible, but not simpler”, and “Only two things are infinite,
the universe and human stupidity, and I’m not sure about the former” are
likely also spurious.
I note that the link to Einstein in each of these cases was not
documented by citing a verifiable source. Moreover, Alice Calaprice, in
her collection “The Expanded Quotable Einstein” (Princeton University
Press, 2000) notes that “Everything should be made as simple” is “possibly
by Einstein” but has never been verified. She dismisses “Not everything
that counts” as “probably not by Einstein”. I fear that “Only two things
are infinite” deserves a similar fate.
What has happened to Einstein illustrates what Ralph Keyes, in his
collection of misquotations, “Nice Guys Finish Seventh” (HarperCollins,
1992) calls the “flypaper effect”, because we have three examples here
where quotes from unknowns have become attached to the name of the famous
Einstein. Because of the ease with which such spuriously attributed
quotations can circulate, the Internet has facilitated this regrettable
phenomenon. This is exemplified by the speed with which the relatively
unknown columnist Mary Schmich’s advice to “Wear sunscreen” became
attached to that of the famous author Kurt Vonnegut (see
http://www.hotink.com/schmich.html).
The lesson for journal editors is clear. Don’t accept quotations
attributed to famous individuals such as Einstein without clear evidence
that they really said them. Because they probably didn’t.
Stephen L. Black
sblack@ubishops.ca
Competing interests:
An unhealthy compulsion to rid the world of spurious quotations; otherwise none
Competing interests: No competing interests