The "Practice" of Medicine

One of the most startling things about working in health care should not be that shocking. But for me, finding out that sometimes doctors don't know what to do was a surprise. I think that doctors deserve a great deal of respect. But, they don't know everything. (Unfortunately, no one does!)

I'm watching the Ken Burns series "The Emperor of All Maladies" (based on the amazing book by Siddhartha Mukherjee) and it's easy to look back with hubris and disdain for the early cancer doctors. What were they thinking with extreme surgery to remove breast cancer that took out half of the woman's torso? How could they use radiation at such high doses that people's noses and fingers were burned or fell off? How could they take chemicals of unknown usefulness and give them to patients? 

Well. While we know so much more about cancer cells now, and the different types, and some of the genetics behind it...we still live in an age of experimentation for some cancers. It is the person plus the disease plus the treatment and it's unknown how it will turn out. The uncertainty is a bit terrifying. 

When I worked with patients with autoimmune disorders, I was always surprised that they didn't know the cause and sometimes didn't know if they had just one disorder. I recently interviewed an allergist who said that he's part detective because there are so many factors in an allergic response. In short, there are still many questions. 

Doctors don't know everything, but I'm reassured that they are on our side in the fight against diseases like cancer. Progress is being made, but we shouldn't forget that there remain many unknowns.  In my opinion, peer-reviewed research, clear and accurate communication and asking lots of hard questions may help us go even further. 

PS Want to read some insightful poetry about being a cancer doctor? HERE