It is a hard lesson in life that many of the most important things that happen to us are beyond our control. Indeed, a large part of wisdom consists of the willingness and ability to distinguish what is and what is not happenstance. The distinction, however, may be very difficult: and while too little fatalism leads to fruitless struggle, too much leads to acceptance of the avoidable.

A recent study from the Mayo Clinic published in the British Medical Journal examines patients with myocardial infarction (heart attack) presenting to hospital out of hours and those who present during normal working hours. They pool the data from all the studies that have been done around the world, and come to the conclusion that patients presenting at nights and weekends have a 5 percent increased risk of death. It therefore seems best, if you must have a heart attack, to have it during regular hours, though this is difficult to arrange for yourself.

Interestingly, subsidiary findings are first that the difference between the death rates has been increasing of late; and second that the difference is less in the United States than in Europe, where it is less than in other parts of the world. Could this mean that, at least in one respect, the American health care system is better than others around the world?