T Ashok @ash_thiru
“It is easy to make perfect decisions with perfect information. Medicine asks you make perfect decisions with imperfect information”.Siddhartha Mukherjee
In this wonderfully thin book “The Laws of Medicine: Field Notes from an Uncertain Science”, Siddhartha Mukherjee investigates the most perplexing cases of his career ultimately identifying three principles that govern modern medicine.
Law One: A strong intuition is much more powerful than a weak test.
“A test can only be interpreted sanely in the context of prior probabilities”
The answer to why a dignified fifty-six-year-old man, from a tiny Boston neighbourhood, who was suffering from weight loss and fatigue was solved by simply getting to know the patient better!
Law Two: “Normals” teach us rules; “outliers” teach us laws.
“Rather than figure out why a drug failed, he would try to understand why it occasionally succeeded “
The strange case of “patient 45,” who miraculously responded to an experimental drug for bladder cancer (patients 1 through 44 weren’t as lucky) was studied deeply by Solit resulting in a discovery of an unusual genetic marker that could identify which future patients could also be helped.
Law Three: For every perfect medical experiment, there is a perfect human bias.
“The greatest clinicians have a sixth sense for bias. What doctors really hunt is bias”
Countless biases pervade the medical literature, even when studies have been randomized and controlled to eliminate prejudices.
Read this brilliant book to understand counterintuitive thinking!