Besides the grey hair, over a decade of practice certainly changes one’s perspective. You’ve had enough time to see things come and go, you’ve had time and interest (hopefully) to dig a little deeper into certain topics and perhaps realize that not everything you were thought in training was entirely true…
There are many reasons behind this, and another perspective that some experience gets you is the appreciation for the human factor and how much is has shaped our “science.” You see, medicine is the nexus of pure sciences (chemistry, physics) and very young and growing sciences (immunology, physiology, biochemistry, etc) all intersecting in the almost-black box that is the human body. On top of this, add the infinite human variability…
Hence, medicine is inherently imperfect. It is part science, and part art. The art is being able to recognize the situations in which the science no longer exactly applies – the patient is no longer a “textbook case” – and you now have to apply your knowledge and extrapolate from the science.
My purpose in joining the online medical community is to play my little part in making our science and our art a little better, not so much by disseminating factual knowledge, but by challenging readers to think and analyze rather than simply follow recipes.
Do you believe, without a doubt that, in 2013, medicine has reached its pinnacle? That there are no further discoveries or innovations to come? That in a hundred years, our young colleagues’ practices will be the same as ours?
If so, well, there probably is no need for you to read on. Seems the doors, sadly, are closed.
If not, then understand that, by Hippocratic Oath or by professional conscience, you are duty-bound to challenge your own knowledge, beliefs and practices until you have written your last prescription.
What does this mean? I’m not suggesting you forget all about guidelines and standards of care and protocols. This isn’t a call to arms against the establishment or authority or a plea to mutiny and chaos. Not at all. It’s a message to medical students, residents and physicians that the onus is on us to critically appraise everything we do from the standpoint of good evidence, physiology and experience, in order for medicine to slowly but surely evolve. It is a work in progress.
So here, I’ll be sharing my thoughts and ideas on various topics, predominantly in the area of internal medicine and critical care, since that is my field. I do hope to challenge beliefs and practices, and welcome – no, hope – for some comments and feedback, because I’m looking to learn from you, too.
Philippe Rola
thinking critical care 