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.
Interpretation
Medicine is not a precise science; it is a complex field filled with uncertainty and variability.
This quote by Atul Gawande highlights the inherent complexities and imperfections in the field of medicine. It acknowledges that while there is a foundation of scientific knowledge within healthcare, factors such as human intuition, habits, and even guesswork are crucial. This reality underscores the challenges faced by medical professionals as they navigate the uncertain terrain of healthcare, where the stakes are high and the gap between knowledge and practice remains ever-present.
In practice
During a medical conference, a speaker may quote this to underline the evolving nature of medical knowledge.
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.
No travel ban or quarantine will seal a country completely. Even if travel could be reduced by eighty per cent-itself a feat-models predict that new transmissions would be delayed only a few weeks. Worse, it would only drive an increase in the number of cases at the source. Health-care workers who have fallen ill would not be able to get out for treatment, and the international health personnel needed to quell the outbreak would no longer be able to go in.
The emotional brain responds to an event more quickly than the thinking brain.
People have always asked whether evolution is constantly driving onwards and upwards. Is there always going to be improvement? The answer is no: evolution is a progression of form and function, but it is not purposeful.
The way life manages information involves a logical structure that differs fundamentally from mere complex chemistry. Therefore chemistry alone will not explain life's origin, any more than a study of silicon, copper and plastic will explain how a computer can execute a program.
In the past, geneticists have looked at so-called disease genes, but a lot of people have changes in their genes and don't get these diseases. There have to be other parts of physiology and genetics that compensate.
The most complex object in the known universe: brain, only uses 20 watts of power. It would require a nuclear power plant to energize a computer the size of a city block to mimic your brain, and your brain does it with just 20 watts. So if someone calls you a dim bulb, that's a compliment.
Those who are not shocked when they first come across quantum theory cannot possibly have understood it.
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