Never Delegate Understanding

Thank you for your interest in my Substack newsletter, Never Delegate Understanding..

Why You Should “Never Delegate Understanding”

That quote from designers Charles and Ray Eames has always stuck with me. It’s a reminder that some things can’t be outsourced. Not if you want to see clearly. Not if you want to act wisely. And certainly not in medicine.

Throughout my career, I’ve learned again and again that the most important insights don’t come from the obvious. They come from digging deeper, from refusing to stop at surface explanations, from asking one more question.

I’ve seen it as a cardiologist at the bedside. As a researcher trying to make sense of complex data. And as an editor at JACC, where every week I’m reminded that the science only matters if we understand what it truly means for people’s lives.

This newsletter grows out of that conviction. I want a space to share not just research findings or policy debates, but the ideas and stories that sit underneath them — the things that require us to stop, look closer, and think harder.

Sometimes that will mean unpacking a JACC editorial or highlighting new research. Sometimes it will mean bringing in a conversation from Health & Veritas, where Howard Forman and I try to make sense of medicine’s biggest questions in real time. And sometimes it will just be a personal reflection — something I’ve been thinking about that connects to how we live, work, and care for each other.

I don’t intend for this to be exhaustive or formulaic. It won’t always have the same sections. But it will always return to the same point: understanding matters. It’s what makes us better doctors, better patients, better partners, better people.

In a world where information moves fast, understanding is the constant we can’t afford to lose.

I hope you’ll join me on this journey.

—Harlan