The 100-Pills Dilemma

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I feel like it’s been long enough since it happened that I can share the following story with you.

Imagine that you’re in the following situation:

You are a doctor.

You work in a charity’s free clinic that serves hundreds of indigent clients every day.

Every day, you dispense free medications to patients who otherwise couldn’t afford them.

One day, for reasons that are completely beyond your control, your pharmaceutical suppliers inform you that your clinic will only be receiving 100 antibiotic pills per day from now on.

But you know that, every day, you have 100 new patients that are going to need that antibiotic.

And you have absolutely no other way to obtain that antibiotic.


The next day, like clockwork, the normal stream of hundreds of patients flows through your office.

One hundred of them need that antibiotic.

But here’s the kicker: It takes 10 antibiotic pills to cure a patient.

If you give a patient anything less than 10 antibiotic pills, they won’t be cured.

If you give 10 pills apiece to 10 of your patients, then those 10 patients are going to be cured.

But your other 90 patients won’t get any antibiotic, so they won’t be cured.

On the other hand, if you give 1 pill to each of your 100 patients, then none of them are going to be cured, because it takes 10 pills to cure each patient.

So, what are you going to do with your antibiotic pills?

Please stop reading right now and think about it for awhile before continuing.


If I were in that situation, I would have to choose to give 10 antibiotic pills apiece to 10 of my patients each day — maybe the ones that need it the most — and not give any pills to my other 90 patients.

Because, that way, at least I’d know that 10 of my patients would be cured each day.

But, faced with that same situation, some charitable organizations would choose to give one pill to each of their 100 patients every day — knowing that one pill apiece wouldn’t do any good at all.

And the reason they would do that is because they know that it looks better on paper to report to their contributors and funding agencies that they “help” 100 patients every day, instead of helping 10 people every day.

Of course those charities know that they really don’t help any of those 100 patients.

But they believe that the charities that they compete against for funding do the exact same thing, so they feel compelled to do it, too.

Because otherwise, they would look bad, compared to the other charities.

And they would lose money and sponsors.

And not be able to help anyone.


And that, my friends, is the main reason why, fifteen months ago, I resigned from working more-than-full-time for an entire year, as a volunteer legal advocate (they called me “an unpaid staff member”) at a domestic violence center.

As a survivor of domestic violence, my priority was to spend the time that it takes to empower victims of domestic violence to change their lives forever.

I loved doing it.

And I was incredibly good at it.

In fact, I learned so much within the first few weeks, that every single victim who I personally assisted with completing their stack of legal paperwork, or who I went to court with, was granted the legal Order For Protection that they needed — even though the courts had already denied some of them an OFP up to three times in the past, before I had helped them.

As my reputation grew, other advocates asked me to help them with their most desperate clients, and many distraught clients specifically requested that I advise them or be their advocate.

Unfortunately, with the economy starting to get bad and many charities’ funding sources beginning to shrivel, the domestic violence center’s leadership chose a different way to deal with “the 100-pills dilemma.”

They demanded that I “give each patient one antibiotic pill.”

So that it would look better on paper.

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