"Imagine watching a train go by. You are looking for one face in the window. Car after car passes. If you become distracted or inattentive, you risk missing the person. Or, if the train picks up too much speed, the faces begin to blur and you can't see the one you are seeking.

...It can become rote, and you stop observing closely. Then you have the endless number of kids who are cranky and have a fever, and it's almost always a virus or a strep throat. They can all blur. But then there is that one time it's meningitis. 

...A blessing, of course, that the kids are fine, but a curse because you can become lulled by the monotony of the mundane. 

..., and not to be lulled into complacency despite her expertise. 

...There were time when I was so spent, and yet still pulled in so many directions by patients in need and nurses demanding action, that all I wanted to do was deflect their requests. Subconsciously, I found myself minimising the severity of a symptom or assuming that an aberrant laboratory result was an artifact rather than a sign of a serious problem... The danger is to stop caring. The goal of each day and each night was simply to move everyone through, to clear the decks, rather than to deliberately and expertly care for those who needed care and reassure those who did not...

...But both McEvoy and Bigby emphasised to me that in the hurly-burly of primary care, a physician must not lose sight of the fact that what may seem mundane to the doctor can strike the patient as tragic."