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that if they combined their administrations, they might achieve significant cost savings and improvements in efficiency. The medical school and the university agreed, and the concept of a neuroscience center was born. The rest is history, as the neuroscience studies at Johns Hopkins achieved worldwide recognition. The strength that was gainedthrough unity was much greater than the individual strength of each separate department.
    Recognizing the power of unity, the Constitution’s framers wrote in the preamble that they desired to “form a more perfect Union.” Our nation had begun as a loosely associated collection of states, each of which acted like a small nation unto itself. There was no central authority to coordinate the collective defense or to facilitate mutually beneficial commercial activities. This left the states vulnerable and directionless in a dangerous world of greedy, predatory nations.
    One of the main purposes of the Constitution was to form an effective union that balanced unity and liberty. The founders of our country recognized that there was tremendous synergy and strength to be gained if the states were united in a meaningful way. Not only would they have a better chance of thwarting attacks by other nations, but they would also have significantly more power when negotiating treaties and trade agreements throughout the world. This union had to be strong enough to provide a united front.
    The union also had to be weak enough not to deprive the individual states of the right to govern themselves. Large states and small states had different needs. Industrial states wanted different rules from agricultural states. Southerners and Yankees thought each other were inferior. A more perfect union would have to be weak enough to allow the states to make their own decisions on some matters.
    But before the delegates could unite the states they would need to overcome their own disunity. Many of them disagreed strongly on the details of how the Constitution should be structured. If they could not stop bickering about these individual points, there would be no hope of forging any Constitution at all.
    Fortunately, the delegates had two strategies. First, they made the Constitution as broad as possible, leaving out details that might cause disagreement. By doing this they made room for compromise and calmed themselves enough to work together. Second, they gave the federal government supreme power—but only in a limited number of areas. This would allow the states enough sovereignty to tailor their governing styles to their individual needs. By avoiding being bogged down in details and by balancing strength and liberty, the delegates created a true union—one more perfect than that effected by the Articles of Confederation.

ESCAPING THE DETAILS TRAP
    Sometimes people get so bogged down in the details and risks of a situation that they miss the big picture that mandates action. I well remember the case of a little girl from Connecticut who fell off a swing in the schoolyard and hit her head, experiencing a postconcussive seizure as a result. No one was overly concerned until she started developing increasingly frequent seizures, up to sixty per day despite medications. After multiple medical consultations, she ended up at Johns Hopkins, where I and the neurology team concluded that she was a candidate for a major surgical procedure to stop the seizures.
    After I explained to her parents the risks of surgery, they decided that they would try to live with the seizures. I understood their fear of the risks, but the decision to avoid these potential problems meant that their daughter would be stuck with guaranteed problems—and still not out of danger. I fearedthat their concern over the surgical risks had kept them from seeing the big picture.
    Then that Christmas she had a grand mal seizure. That was enough to persuade her parents to proceed with the surgery despite the risks. Although the surgery went well, she