Hickam’s Dictum
The Path to Inclusion Runs Through Human Complexity
More people know and quote Occam’s razor — that the simplest explanation is usually the best — because it appeals to our craving for ease and clarity. However, life doesn’t give us the luxury of living that simply, especially when we are working on complex issues that have multiple forces at play, such as DEI.
In medicine, Hickam’s dictum pushes back on the neatness of Occam’s razor. A doctor named John Hickam used to tell his students, “Patients can have as many diseases as they damn well please.” It was his way of saying, “stop looking for the one elegant answer when real life is rarely that tidy.”
The same principle applies to DEI work. We often want to diagnose inequities as if they stem from a single condition: “It’s a pipeline problem.” “It’s unconscious bias.” “It’s a lack of sponsorship.” These explanations are easier to name and prescribe a quick fix for, but they distort and miss the truth. Inequities, like illnesses, rarely occur in isolation. They layer. They interact. They complicate each other. What appears to be a “pipeline problem” may also be a cultural weakness, a leadership dysfunction, a policy weakness, and the long shadow of history, all operating simultaneously.
Hickam’s dictum reminds us that complexity isn’t failure; it’s reality, it’s the truth. Just as a patient can have diabetes, anemia, and arthritis all at once, with each symptom complicating the others, an organization can be carrying outdated promotion criteria, unacknowledged bias, and systemic barriers. Treating one condition without addressing the others may relieve symptoms, but it won’t restore health.
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When we apply Hickam’s wisdom to DEI, we remind ourselves to:
- Look at the whole body, not just the symptom. The truth often hides in what we don’t initially examine.
- Treat multiple systems at once. Just as the heart, lungs, and kidneys all interact, inequities across policy, culture, and leadership must be addressed together.
- Acknowledge intersectionality. People don’t live their identities one at a time any more than the body functions one organ at a time.
- Stop searching for miracle cures. Inclusion isn’t solved with a single shot of anything; it requires ongoing care, layered treatments, and constant monitoring.
Complexity isn’t the enemy; it’s the human condition. And leaders who can see the whole system, diagnose its interconnections, and care for it with complex precision and patient compassion are the ones who turn inclusion from an initiative into a way of being.
Hickam’s Dictum is not the easy path, but it is the only nonperformative path to creating real and sustainable change.
