The possibilities and probabilities are all we have to work with in medicine, though. What we are drawn to in this imperfect science, what we in fact covet in our way, is the alterable moment-the fragile but crystalline opportunity for one's know-how, ability, or just gut instinct to change the course of another's life for the better.
Interpretation
Medicine is an imperfect science, and it relies on our skills and instincts to make a positive impact on lives.
In this quote, Atul Gawande emphasizes the inherent uncertainties in medicine, highlighting that although it operates within the realm of possibilities and probabilities, it is the 'alterable moment' that truly matters. This moment represents the opportunity for healthcare professionals to use their knowledge, skills, and intuition to make a meaningful difference in the lives of their patients, reflecting the delicate balance of science and the human touch in medical practice.
In practice
During a medical conference, a speaker might use this quote to emphasize the importance of skill and instinct in patient care.
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'm not going to sacrifice my mental health to have the perfect body.
I read somewhere that when a person takes part in community action, his health improves. Something happens to him or to her biologically. It's like a tonic.
There is a glaring reason that the necessary total ban on nontherapeutic use of antibiotics hasn't happened: The factory farm industry, allied with the pharmaceutical industry, has more power than public-health professionals.
I believe well-designed places and objects can actually improve healing, while poor design can inhibit it.
I am one of millions who have been treated for depression and gotten well; I was lucky enough to have a psychiatrist well versed in using lithium and knowledgeable about my illness, and who was also an excellent psychotherapist.
We know from our clinical experience in the practice of medicine that in diagnosis, prognosis, and treatment, the individual and his background of heredity are just as important, if not more so, as the disease itself.
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