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.
One aim of physical sciences had been to give an exact picture the material world. One achievement of physics in the twentieth century has been to prove that that aim is unattainable.
The problem of neurology is to understand man himself.
What do you think science is? There is nothing magical about science. It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. So which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?
The observation that species are amazingly conservative and static entities throughout long periods of time has all the qualities of the emperor's new clothes: everyone knew it but preferred to ignore it. Paleontologists, faced with a recalcitrant record obstinately refusing to yield Darwin's predicted pattern, simply looked the other way.
It {Darwin's theory of evolution] was a concept of such stunning simplicity, but it gave rise, naturally, to all of the infinite and baffling complexity of life. The awe it inspired in me made the awe that people talk about in respect of religious experience seem, frankly, silly beside it. I'd take the awe of understanding over the awe of ignorance any day.
[A]ll knowledge is one. When a light brightens and illuminates a corner of a room, it adds to the general illumination of the entire room. Over and over again, scientific discoveries have provided answers to problems that had no apparent connection with the phenomena that gave rise to the discovery.
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