The team was there today. That is not a guarantee.

The Signal named the exodus. The Briefing named the levers. Today’s Viva Voce is the case.

A forty-two-year-old. A fourth cesarean. A spinal that failed. The plan changed across the drape. The team was there to catch it.

Four highly trained clinicians. Four different decision trees. A twenty-minute window. Any one of them could have been the rate-limiting step on the patient’s survival.

What I do not think about during the case is the workforce composition that put the team in the room. What I think about, an hour later, writing the operative note, is who would have done the case if the team had not been here.

The team was there today. That is not a guarantee. That is, for now, a fact.

Read the full Viva Voce

From Earlier This week:

The Signal: The OB/GYNs Are Leaving. The Replacements Aren’t Coming. — Twelve years to make one. Five years to break the pipeline. Idaho is the case study.

The Signal

The Breifing: When the last OB/GYN leaves a rural county and the hospital closes its labor and delivery unit, here is what happens to the pregnant woman who lives there.

Read the full Briefing

Read the full series:

Series 1 · Quiet Dismantling

Bring The Bolt Cutters just dropped 3 more receipts.

Receipt #2 : Federal agencies have scrubbed “Black” from health data. You cannot fix a crisis you cannot name.

Receipt #3: Texas passed a bounty law—$100,000 to sue anyone who supplies abortion pills to a Texas resident.

Receipt #4: Louisiana indicted a New York doctor. This is the first cross-state criminal prosecution of an abortion provider since Dobbs. It is the template.

You can read me anywhere. There are louder takes. There are faster newsfeeds. There are bigger names. What you get here that you don’t get anywhere else is THE SPINE — a permanent argumentative scaffold you can stand on, walk along, share with the people you’re trying to convince, and keep coming back to over years.

The reason your premium went up $1,000. The reason your sister’s cancer trial got pulled. The reason Pap smears are disappearing from rural counties.

THEY ARE THE SAME REASON.

That’s the case we’re making, week after week, until the country can see it.

Thank you for being here. Forward this to one person who needs the spine.

— YC

Founder & CEO, Diosa Ara | Creator & Editor-in-Chief, The Labora Collective