Uncertain Certainty

"The problem in medicine is, the body is complex and our knowledge is incomplete. People who want certainty – physicians or patients – are kidding themselves"

The patient perspective is sometimes sobering.

E-patient Dave deBronkart, writing online from the patient's perspective, grabbed my attention with "Expecting Doctors to be Perfect is a Setup for Dysfunction"

And the corollary from the e-doctor perspective is "Expecting ourselves to be perfect is dysfunctional", yet it is the core of performance in post-doctoral training. And with so any being intellectually perfect, the stakes are higher and more significant.

Mr. deBronkart quotes a study involving after death autopsies stating that 10-15% of "cause of death" and "final diagnoses" are actually incorrect. I'm not surprised. We have so much technology but so little real insight into disease particularly when it involves multiple systems. It's not that we don't care, or don't want to do good...we do. But..."the body is so complex and our knowledge so incomplete" that we can't be certain at all.

But the system deals regularly in absolutes, teaches great certainty, extolls the virtues of greater insight into our belief system. It's a mismatch with the true reality of what is. And it's what makes learning in this bad system even worse. I'll go out and do my best today, with the limited knowledge I have, about the complex systems we deal with, and try to make sense of the environment that creates uncertain certainty. At least, I'll certainly try to be as certain as uncertainly possible. Of that, I'm certain.