Herodotus, the ancient Greek historian, tells the story of how the Babylonians in 500 B.C. diagnosed and treated their illnesses. The Babylonians did not have physicians. When they became ill, they went to the city square where they would tell anyone who came to the square about their symptoms. Their fellow citizen would then explain that they once had similar symptoms or that they knew someone who had similar symptoms. They would then offer advice about the remedy that they used to cure the illness. There were wild tales of miracle cures. Herodotus does not comment on how effective the treatments were, but the Babylonians believed in them and used the system for many years.
Modern-day medicine is based on scientific method which was developed in the eighteenth century during the Age of Reason. This method relies on the principle of proposing a hypothesis of how something works and then testing that hypothesis. Medicine is classified as a science because it is based on scientific principles, but medicine is as much an art as it is a science. One of my medical school professors taught me that the most effective way to learn medicine is to go from the textbook to the bedside and back to the textbook. In other words, the student physician should learn the basic science of medicine and then go to the patient with this textbook knowledge and then return to the textbook to learn more about the patient’s diagnosis and treatment. Physicians do not just plug in a list of symptoms into an algorithm and come up with a diagnosis. They use their knowledge and experience to create the art of medicine.
Dr. Internet
Herodotus’ story about the Babylonians reminds me of the way people use the internet to diagnose themselves. I have patients come to me with information that they have found on the Internet about their illness and how to treat it. I encourage my patients to learn as much as they can about their own symptoms and illnesses so that they can improve their health. However, I do emphasize that they should seek expert guidance before treating themselves. There is so much information on the Internet which can be overwhelming even to an expert. The Internet should be the starting point for understanding more about an illness, but it should never be the final diagnostic tool or treatment.
Diagnosis and treatment is like the art of cooking. Most adults know how to cook, but what they prepare at home usually does not match the taste or quality of the meal that a five-star chef creates. Amateurs may be able to read and follow a recipe, but there is much more to food preparation than measuring the ingredients and applying heat. Most people who search for symptoms and diagnoses on the Internet are intelligent enough to be able to understand what they read, but there is much more to diagnosis and treatment than just matching symptoms with a list of ailments and matching treatments with a list of diseases. Medicine is more of an art than a science. It takes many years of training and experience to develop the skills necessary to diagnose and treat even the most common illness. The physician must go from the textbook to the bedside and back to the textbook.
The Masterpiece of Medicine
The brain is able to process thousands of bits of information in just a few seconds, but most of that processing occurs unconsciously. There are more subtle clues in a patient’s mannerisms or in a simple examination than can be processed consciously by the brain of the physician. What a physician describes as a gut instinct about a diagnosis is much more than that. It is the culmination of years of experience and knowledge that allows a physician to sift through all of the information presented and come up with a specific diagnosis and treatment. A physician is like the artist who has a few simple colors on his palette, but can transform the simple colors into an amazingly complex and beautiful piece of art.
There are no perfect paintings, although some works of Leonardo da Vinci or Picasso may come close. Physicians are not omniscient, but they have invested most of their lives acquiring their knowledge and skill. They apply their knowledge, which is based on sound scientific principles, to diagnose and treat their patients. The Babylonians had neither scientific method nor the art of medicine. The Internet is a useful resource, but it cannot replace the physician’s mastery of their art.
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