Our great struggle in medicine these days is not just with ignorance and uncertainty. It's also with complexity: how much you have to make sure you have in your head and think about. There are a thousand ways things can go wrong.
Interpretation
The challenges in modern medicine stem from both a lack of knowledge and the intricate complexities of healthcare.
Atul Gawande highlights the dual challenges faced in medicine today: the persistence of ignorance and uncertainty, alongside the overwhelming complexity that medical professionals must navigate. As advancements in medicine continue to grow, the amount of information and potential risks increases, making it crucial for practitioners to stay informed and aware of the numerous factors that can affect patient outcomes. This quote encapsulates the intricate balance required in the healthcare field—where both knowledge and critical thinking must be applied to manage the vast landscape of possibilities and challenges.
In practice
This quote could be used in a medical conference presentation to emphasize the need for continuous education.
A failure often does not have to be a failure at all. However, you have to be ready for it-will you admit when things go wrong? Will you take steps to set them right?-because the difference between triumph and defeat, you'll find, isn't about willingness to take risks. It's about mastery of rescue.
No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.
Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.
When I do an operation, it's half a dozen people. When it goes beautifully, it's like a symphony, with everybody playing their part.
At times, in medicine, you feel you are inside a colossal and impossibly complex machine whose gears will turn for you only according to their own arbitrary rhythm. The notion that human caring, the effort to do better for people, might make a difference can seem hopelessly naive. But it isn't.
We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.
I remember my friend Johnny von Neumann used to say, 'with four parameters I can fit an elephant and with five I can make him wiggle his trunk.'
Only six men in the world know about relativity. I am not one of them. When I ask them to explain, they confused me.
My own field of paleontology has strongly challenged the Darwinian premise that life's major transformations can be explained by adding up, through the immensity of geological time, the successive tiny changes produced generation after generation by natural selection.
Having been the discoverer of many splendid things, he is said to have asked his friends and relations that, after his death, they should place on his tomb a cylinder enclosing a sphere, writing on it the proportion of the containing solid to that which is contained.
What's been gratifying is to live long enough to see molecular biology and evolutionary biology growing toward each other and uniting in research efforts.
I am not very sceptical, — a frame of mind which I believe to be injurious to the progress of science. A good deal of scepticism in a scientific man is advisable to avoid much loss of time, but I have met with not a few men, who, I feel sure, have often thus been deterred from experiment or observations, which would have proved directly or indirectly serviceable .
Subscribe for the occasional hand-picked quote. No noise.