Symmetry, until the recent intellectualization of life, had been implicitly considered the principal rule in dealing and trading with others. The very idea of law – even divine one- is to rule imbalances and remedying the possible asymmetries.

Hammurabi’s law was posted on a stone stele around 4000 years ago in a central public place in Babylon, so every person could read it. It contains 282 laws. The code has one central theme: it establishes symmetries between people in a transaction.  Whoever would transfer hidden risks and cheat others, they should pay the price for it.

Hammurabi’s best known laws was:  “if a builder builds a house and the house collapse and caused death of the owner of the house – the builder should be put to death“.

The other famous law from Hammurabi’s code is the so called Lex Talionis, “an eye for one eye, a tooth for a tooth“. It is of course metaphorical and not literal: you do not need to extract the tooth of the dentist who pulled out the wrong tooth. The tort system, through courts, will impose some penalties, enough to protect customers.

Nassim Taleb tells of an English banker who once said him :” I  give long-term loans only. When they mature I want to be long gone. And only reachable long distance.” Taleb goes on telling that the banker worked for international banks and survived playing his trick by changing country every five years, and he also changed wives every ten years and banks every twelve.

Most of Roman emperors died in battle. Alexander, Hannibal, Scipio, and Napoleon were not only first in battle, but derived their authority from a disproportionate exhibition of courage in previous campaigns. Courage is the only virtue that can’t be faked (or gamed like metrics). Lords and knights were individuals who traded their courage for status, as their social contract was an obligation to protect those who granted them their status. This primacy of the risk-taker, whether warrior (or, critically, merchant), prevailed almost all the time in almost every human civilization. But Bureaucracy has introduced a big asymmetry in the system, ruining it.

Now we are full of policymaking “clerks”, journalist, economists, academicians, politicians – all that class of paternalistic semi-intellectual experts with some Ivy league, Oxford-Cambridge-Harvard, or similar label-driven education –  who are telling the rest of us 1) what to do, 2) what to eat, 3) how to speak, 4) how to think… and 5) who to vote for.

Those members of the “intelligentsia” –  who will not able to find a coconut in Coconut Island –   has the only capacity to pass exams written by people like them. They has been wrong about most of the theories they have dreamed about: Stalinism, Iraq, Libya, Syria, lobotomies, Gaussianism, p-values, etc.

But they have never payed the price for their mistakes. Other people payed for their mistakes.

We all have naively experienced the same lesson “Beware of the person who give you advices, telling you that a certain action on your part is “good for you” while it is also good for him, while the harm to you does not directly affect him

If you have the reward, you must also get some of the risks, not let others pay the price of your mistakes. If you inflict risks on others, and they are harmed, you need to pay some price for it. If you give an opinion, and someone follows it, you are morally obliged to be, yourself, exposed to its consequences.

In case an economist gives you an advice, you should answer him “Do not tell me what you think, just tell what’s in your portfolio”

In case a dentist gives you an advice, you should answer him “Do not tell me what you think, show me your mouth”.  You are going to discover a monstrous asymmetry among what dentists suggest to the patients and their mouths status. 

In case of an architect gives you an advice, you should answer him “Do not tell me what you think, show me first your house”

In the ancient Greece, in the maritime transactions,  there was law called “Synkyndineo” meaning “taking risk together”, the concept of risk sharing.

In the relation doctor-patient, there is obviously an asymmetry, because we-doctors know more than our customers about the pathology, the treatment and its risks and benefits. The only way we have to increase the symmetry in our mutual relation is to share the risks and get some penalties in case of harm. In case of success (yet not depending on us…and sometimes DESPITE US!!!)  we-docotrs have a lot of advantages: 1) pride 2) economical reward 3) good word of mouth (more patients…more money).

But what in case of failure? What in case of harm? I l always say the patients that in case of failure-harm, I shall pay economically. He’ll pay biologically. It is not so much, but I think it is a signal for the patients showing transparency and symmetry.

Building symmetry, it is the best way to build an Healthy Practice.

Having the office in the same place for 20-30-40 years….living in the same ares of the office and meeting everyday on the streets your patients….doing in the patient’s mouth what we have in our mouths – are other ways to build Symmetry and Legacy.