The Laws of Medicine

In The Laws of Medicine Siddhartha Mukherjee uses his words and storytelling to elaborate on medical realities learned from invaluable education and experience.  Mukherjee is sets out to describe principles of medical practice, pointing out that practicing medicine is about knowing the strengths and weaknesses of knowledge gleaned from patients, tests, experiments, and one’s self, then making the best decision with that information. Mukherjee much more eloquently elaborates on that point, emphasizing his three “laws” or principles of medicine.

  • Before Mukherjee describes the three principles of his book, he sets them up in a forward. He wonders if medical jargon is partly subconsciously employed to escape unknowns. He briefly discusses the history of medicine from the cure-all treatments of the 1800’s to careful observance of the Hippocratic oath, using William Osler as an example. He mentions Lewis Thomas’s The Youngest Science: Notes of a Medicine Watcher. He is careful to differentiate the “laws” he is about to expose from more pure scientific laws such as those in Physics, Chemistry, and Biology.
  • Mukherjee explains that assessing a patient involves raising or lowering the probability of a diagnosis through interpreting test results in context. Mukherjee uses Thomas Bayes, an 18th century Philosopher and Clergyman, to illuminate the imperfect nature of tests.
  • Mukherjee continues his excellence use of relevant storytelling to explain how the unexplained abnormal results of tests or experiments are keys to better understanding of the whole. Hearkening back to history once more, Mukherjee uses Karl Popper’s The Logic of Scientific Discovery to point out that medical knowledge is scientific only when it carries a stipulation that can disprove it by new information or discovery.
  • Mukherjee adapts Heisenburg’s uncertainty principle to medicine to question how generalizable experiments are. He mentions that Paul de Kruif’s Microbe Hunters may have been apt in the early 20th century, but here in the 21st century bias is the prey of physicians. Mukherjee reflects on the role of physicians to hunt bias, including their own, while using imperfect information to help patients make the best decisions about their health.

In The Laws of Medicine, Mukherjee impresses a sense of understanding upon the reader through taking complex issues and breaking them down into manageable pieces of information. He doesn’t need to explain the science behind his examples to give the reader a little understanding of the big picture. Furthermore, bleeding through the pages are rich examples of medical history that incite an appreciation for great minds that have come before Mukherjee’s imparting knowledge for him to build upon.

Another theme of Mukherjee’s book is the uncertainties of the medical field. His comments on medical jargon and the imperfections of tests are humbling. Still a relatively young science, medicine continues to experience a boom in information and technology. These advancements may clarify some things while opening up new areas vast with questions.

Studies, companies, and patients all have opinions on medicine, and it seems correlations are often unexplained while being sold as causation to the public. Statistics, anatomy, physiology, epidemiology, pathology, advanced mathematics, history, etc. are subjects each worthy of in-depth study, but combine all of those subjects while adding many others and you will begin to understand the challenges of medicine. It’s edifying to see an author acknowledging the difficulties of his field while simplifying the principles within it.

With all the avenues with which information and opinion is accessed in today’s world, it is difficult to focus on what matters most. Focus is what Mukherjee encourages with his three laws of medicine. Sifting through a myriad of information to find relevance seems an ever-increasing challenge among today’s youth, whether or not they are interested in practicing medicine. With the precision of a great writer, Mukherjee illuminates invaluable principles learned through a wealth of experience. These principles help thin the overwhelming fog of information to be processed, and if put to use are likely to improve the work of those practicing medicine.

Mukherjee’s The Laws of Medicine is a short and worthy read for anyone interested in the practice of medicine. At less than 100 pages, The Laws of Medicine seems Mukherjee’s most concise and easy read as his other books, The Gene and The Emperor of All Maladies: A Biography of Cancer, are both over 500 pages. The Emperor of All Maladies: A Biography of Cancer was awarded the Pulitzer Prize for General Nonfiction in 2011, and Mukherjee has also written for NEJM, Cell, Nature, and The New York Times.

 

The Real Doctor Will See You Shortly

TheRealDoctorWillSeeYouShortly

The Real Doctor Will See You Shortly by Matt McCarthy is a book about the author’s first year as a resident after graduating from Harvard Medical School. The book is a raw story about the stressful ups and downs of life as a medical resident. Not all residents may feel the same kind of stress or sense the same kind of life-altering experiences that Doctor McCarthy reflects on in his book, but the experiences of residents must have a large impact on the courses of their futures as physicians. McCarthy’s book demonstrates how his experiences have impacted his career, and provides a valuable resource for students aspiring to a career in medicine.

The book opens with McCarthy exiting the world of academia for the work of residency. He travels from the cardiac care unit to a local outpatient clinic to the infectious disease service to the general medicine floor to intensive care unit during his residency at Columbia University Medical Center. He exchanges 2nd year resident mentors for which he has a constantly changing “scut” list of services to provide for patient care. He experiences triumphs and tragedies as he endeavors to survive his first year of residency.

McCarthy has authored other books, and his writing is not bland or above the level of the reader. He shares mnemonics like “ABC”, “VINDICATE”, “AEIOU”, and “NAVEL” to illustrate the rigors of remembering keys to good patient care, but he never expects the reader to take an interest in the academics of medicine. McCarthy writes for the sake of the story. He describes the emotions of patients and their caregivers, he illustrates the harsh physical realities of diseases and medical procedures, and he reflects on the good and bad things about life as a resident.

McCarthy also demonstrates a refreshing sense of humor and humanity. He makes corny jokes, illustrates some humorous situations that often arise in healthcare, and talks about the importance of periodically cutting loose from the serious nature of medical care. Healthcare professions can be a frustrating, and McCarthy’s humor provides welcome relief for the doctor and the reader.

The Real Doctor Will See You Shortly is a good read, especially if one is interested in working in the medical field. Working as a Medial Doctor is a very well-respected job for many reasons. The hard work and discipline that it takes to graduate from Medical School demonstrates a willingness to sacrifice time, energy, and wealth to achieve an admirable goal, and more importantly, providing quality patient care demonstrates a dedication to protecting the lives of others. As more readers delve into the pages of Dr. McCarthy’s telling first year, perhaps their confidence to sacrifice time, energy, and wealth for the sake of those who lack access to quality healthcare will grow as well. After all, it is not easy, becoming a doctor, but for the sake of others, it’s definitely worth it.