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“This is where science becomes an art.” Whenever a medical doctor says her work verges into artwork my ears perk up. Last summer I was diagnosed with hyperthyroidism, what I came to discover is a common malady. My exceptional endocrinologist immediately eased the symptoms with medicine. But the meds had to be modulated – when and how much to take, was the issue for my body. That’s when I heard the phrase, sometimes, “science becomes an art."
We live in a place and time where physicians are doing great work. I was so thankful to feel better with the right pharmaceuticals. But the application, the exactitude of complete wholeness, can be elusive. Some of the most renowned doctors and researchers are, at times, left scratching their heads. Knowledge continues to double daily, but the use of that knowledge can be a mystery. Medical surgeon and author Atul Gawande says in his book Complications: A Surgeon’s Notes on an Imperfect Science
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.
Ancient proverbial wisdom is a guide for modern medicine. Proverbs 10.14, says, “The wise store up knowledge.” The Hebrew word for “store” suggests “seeking.” No matter our vocation, we continue searching but sometimes the application of what we learn is hard to practice. Here Proverbs 15.7 speaks more truth: the wise person also spreads knowledge, feeling responsible to disperse her mastery to benefit the whole community. My doctor is right to acknowledge that she continues to learn, for which I, and countless others, are grateful. For the Comenius Institute, this is Dr. Mark Eckel, Executive Director of the Center for Biblical Integration at Liberty University, personally seeking truth wherever it’s found. [First published at MarkEckel.com]
More from Atul Gawande
I have divided the book into three sections. The first examines the fallibility of doctors…The second focuses on mysteries and unknowns of medicine…The third and final section then centers on uncertainly itself. For what seems most vital and interesting is not how much we in medicine know but how much we don’t—and how we might grapple with that ignorance more wisely.
Discussion (6)
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Our family got a vivid introduction to "medicine as art" about thirty years ago when my father got a severe infection in one of his legs (ten weeks in the hospital, 8 of those in intensive care). There was a lot of "let's try this and see if that helps" going on because of the unpredictability of how his body reacted to different treatments. He barely felt pains that would cause most people to scream in agony. But he'd hallucinate. And even small amounts of pain killers put him to sleep for a day or more. After a while the medical people decided some of infection conditions looked somewhat like burn wounds, and so they tried treatments normally used for burn patients, and they worked on my father's infection.
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Sometimes the art of medicine leads to horrors like transition surgery.
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As the old saw goes: There are three types of medicine. First, evidenced based medicine. Unfortunately we have very little good evidence on which to base decisions. Second, eminence based medicine in which we follow the advice of the Gurus. And finally, the medicine we mostly practice, faith based medicine.
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Pretty sure if it was that bad we wouldn't go to Doctors.
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Have you been to a doctor lately?
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