The Laws of Medicine: Field Notes from an uncertain scientist by Siddhartha Mukherjee
Dr. Mukherjee is a cancer physician who was being interviewed
In the first few
I think that sets a much-needed tone in the arena of medical interventions. If you come across someone, patient or provider, that is convinced beyond a reasonable doubt of exactly what the ailment is and precisely the single best way to fix it – pause. Medicine is extremely humbling, even beyond the challenge we have gathering relevant information, is that many (if not most) conditions are multi-factorial.
Law One: A strong intuition is much more powerful than a weak test
This picks up on the thought above of so much of illness being multi-factorial. , gave an example of a patient he had done everything for in a textbook fashion, but still wasn’t making progress. Then by a chance observation, he saw this patient talking to a patient in the medical facility lobby that was an IV drug user who had HIV. With this new context, he ran a confirming test and got an AIDS diagnosis. He didn’t do anything out of protocol, but it was this chance moment that caused his intuition to look deeper.
I have experienced this a few times. Looking through some of the Success Stories, sometimes it is an
Law Two: “Normals” teach us rules; “outliers” teach us laws.
The takeaway from this law is that there is much to learn from the exceptions to the proverbial rule. Taking the time to understand why someone doesn’t succeed in a trial where most due is, something he pointed out, is overlooked. An example used was one patient who responded amazingly well to a new bladder cancer drug. Instead of casting her an outlier, an analysis of the cancer genetics was performed and they found a gene that will signal when this drug will work and when it won’t.
Law Three: For every perfect experiment, there is a perfect human bias.
This one really stood out to me. Bias has to be acknowledged and discussed to bring proper context to all presentations. I have logged a few obvious examples of this in the FAKE HEALTH NEWS tagged articles of the blog. But even more subtle than that is the filtering of info through all of our established lenses. One example from the book was people who were diagnosed with cancer
The other thought that came to mind on Law Three was that bias is not inherently bad. We all
I enjoyed this short read and believe it will be something to look back on periodically to put a proper perspective on various findings and discussions in the medical field.
This Book Report collection is meant to provide some of the best take-home points from the health and science genre I read. I will continue to go thru my notes of the 160+ and counting (as of January 2019) Kindle books I have on file. To view ALL the notes I saved on this one AND many others without a Book Report post yet, THAT IS ALSO SEARCHABLE, please click here.