The rule for effective governance is simple. It is one Ronald Reagan knew by heart. And one that he successfully employed with Social Security and the Cold War. When there is a problem you fix it. That is the job you have been sent to do and you cannot wait for someone else to do it for you.
Just the actual physical ability to hold four instruments simultaneously and do some of the things that Vivien was able to do is mind blowing to any surgeon. He never went to medical school and he became one of the great teachers of medicine himself people are just amazed.