Saturday, December 26, 2015


Here's a lovely article by David Silbersweig about the importance of liberal arts training for those in the medical profession.  Of course, his argument would apply to any profession, but it has particular relevance in this one, where the tendency to rely on the "hard sciences" is emphasized even in the undergraduate years. Excerpts:

[M]y thoughts returned to my sophomore year at Dartmouth, when I went back to my childhood dentist during a school break.

In the chit-chat of the checkup, as I lay back in the chair with the suction tube in my mouth, he asked: “What are you majoring in at college?” When I replied that I was majoring in philosophy, he said: “What are you going to do with that?”

“Think,” I replied.

And what a continuously giving gift philosophy has been. While it seemed impractical to my dentist, it has informed and provided a methodology for everything I have done since. If you can get through a one-sentence paragraph of Kant, holding all of its ideas and clauses in juxtaposition in your mind, you can think through most anything. If you can extract, and abstract, underlying assumptions or superordinate principles, or reason through to the implications of arguments, you can identify and address issues in a myriad of fields.


The ability for a single person to have access to a broad array of disciplines within his/her own brain-mind [allows] for certain insights and nimbleness of thought. Collaboration among such multidisciplinary individuals can take ideas and methods to the next level, resulting in new, unforeseen possibilities.


If we are to remain at the forefront of knowledge creation in this changing, globalizing world, then our students must be the next generation of explorers. We have a sacred obligation as educators, role models and mentors to ensure a system that promotes the attributes conducive to their success. A broad yet rigorous education will best equip them to go forth into uncharted territory to address issues of import to humanity in a creative fashion.


nonlocal MD said...

The impetus to admit medical students with majors other than in the sciences has been going on at least since I entered med school in 1973. What is lacking, to my knowledge, is any sort of study on whether this has made any difference to patient care. One of the first things you learn in medicine (and perhaps many other fields) is that having something seem intuitively obvious doesn't make it true.

e-Patient Dave said...

I'm all for deep thinking - absence of it is the root of so much mischief, especially so much misinterpretation of data, so many off-target inferences, and especially regarding a liberal education, too narrow a scope when considering implications of a choice.

At the same time I shudder at the idea that someone might decide to study philosophy (the love of knowledge, per se) thinking it alone will earn them a living. It seems that better thinking is a fundamental skill, not a profession itself - not unlike reading and writing, yes?

I'd note, too, that in training our clinicians, there are other gaps that need attention. Eight years ago one of my earliest posts, in my e-patient awakening, was about a then-new report about statistical illiteracy among docs(!). (Hm, I just re-read that whole thing and it's better than I remembered.)

The most recent essay on the need for good thinking in medicine is Malcolm Gladwell's appalling New Yorker piece this month, "Tough Medicine," which recounts the utterly disgusting scientific sloppiness at Memorial Sloan Kettering (see the 1970 anecdote). You and I as then-undergrads would have been assassinated for doing a lab experiment the way those researchers did, changing the protocol and then declaring that the protocol didn't work. Unbelievable!

How well we think does indeed matter. Not just as a feel-good nicety - people come up with WRONG ANSWERS if they don't know how to think well. And scope of that thinking matters.

Here's to the wonderful smart (and tough) people in the field who have heart, brains and spine, all in one.

Thomas said...

Agree. Wish I had been an English major instead of pre-med. Didn't know I could do that. Did make a good choice and took a year of Internal Medicine before my OBGYN residency. Same reason; taught me how to reason on medical terms.