Trust is a foundational value for any civilization. When you arrive at your local Kwik-E-Mart, you want to know when you hand over your dollar bill, that your 99 cent can of Arizona Iced Tea isn’t filled with battery fluid and will be as fresh and saccharine as the first time you had it. The cashier on the other side of the counter wants to be assured that your dollar bill is an actual dollar bill rather than a counterfeit one that won’t work when he has to purchase the mango chutney his wife keeps hounding him to pick up on the drive home. Without trust, any number of human to human transactions would be fraught with doubt, fear, and one too many side-eyed glares.

A few weeks ago, I looked at an arterial blood gas reading in my hospital’s electronic medical record (EMR) for a patient whose care I took over when he suddenly and strikingly became short of breath. I immediately noticed something odd. The numbers were perfect. Usually, when something is catastrophically awry with someone’s biology, an arterial blood gas will let me know, the numbers in the EMR blaring a firetruck red so that I’ll be properly alarmed by the physiologic offense. But what I read was a normal blood pH, a normal carbon dioxide, and a normal oxygen saturation. There wasn’t a hint of lactic acidosis, an organic acid that reliably spills from tissues at times of profound stress.

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