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.
Let me lay my cards on the table. If I were to give an award for the single best idea anyone ever had, I'd give it to Darwin, ahead of even Newton or Einstein and everyone else. In a single stroke, the idea of evolution by natural selection unifies the realm of life, meaning, and purpose with the realm of space and time, cause and effect, mechanism and physical law. It is not just a wonderful idea. It is a dangerous idea.
I would suggest that science is, at least in my part, informed worship.
We have also arranged things so that almost no one understands science and technology. This is a prescription for disaster. We might get away with it for a while, but sooner or later this combustible mixture of ignorance and power is going to blow up in our faces.
Science sent the Hubble telescope out into space, so it could capture light and the absence thereof, from the very beginning of time. And the telescope really did that. So now we know that there was once absolutely nothing, such a perfect nothing that there wasn't even nothing or once.
There is no great invention, from fire to flying, which has not been hailed as an insult to some god.
Cognitive psychology tells us that the unaided human mind is vulnerable to many fallacies and illusions because of its reliance on its memory for vivid anecdotes rather than systematic statistics.
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