I was having a lovely family dinner with my mommy and daddy and baby brother, who is in his first year of residency in Emergency Medicine .

My brother pulled out his iPhone. Wanna see what I do at work?

Not really, I said.

He offered up his phone anyway. On the screen was an x-ray image of a human pelvis. This patient came in to the ER last week, he said. He was 70 years old.

A shadowy cylinder floated above the gaping pubic bone.

What the hell is that??

A bottle, he said. I spent an hour and a half trying to pull it out. I finally had to send him to the OR.

AUGGHHHHHH, my mom said.

He was 70??

And I thought my job sucked.

It turned out that the attending physician later reproached my brother for waiting so long to send the patient to surgery. It shouldn’t have taken you 90 minutes to realize that this wasn’t working, the attending said. You wanted to avoid doing the hard thing.

Ah, the hard thing. Ben Horowitz writes all about Hard Things. He says that the two key characteristics that he and his partners look for when investing in entrepreneurs are brilliance and courage. The correct decision is often obvious, the hard part is having the courage to act on that decision. Sometimes it involves changing direction, sometimes it involves shuttering a company, sometimes it involves major surgery to remove an object lodged in an orifice.

Doing the easy thing incurs technical debt, management debt, and prolonged suffering. When in doubt, do the Hard Thing.