Certainty in medicine is a systemic illness fueled by an inflated self-regard and arrogance of many medical providers and their educators. It is born of a need to know - at all times - and to be always right - because that’s how it has always been for thousands of years. Just look at the genius of Hippocrates, Galen, Pasteur, on and on as advances in medicine marched forward!
In the glare of these rare superstars it becomes easy to ignore the relentless and unnecessary harm caused to millions by average clinicians over the ages. Everyday medicine for thousands of years has been based in large part in quackery and historical certainty. If this fact wasn’t ignored, if the focus of medical history was based more on our mistakes and less in historical fantasy, physicians today would be less prone to certainty and the harm it can cause.
Certainty over the ages in medicine has in great part been fostered by deference to a false history that focuses more on the giants in medicine and their incredible feats. Thus blood letting wasn’t just a last ditch effort to save - it was a therapy wrapped in historical certainty - despite it not working for thousands of years. Galen was quite certain it worked, and so am I said the average physician for 2,000 years. Never mind the millions it harmed.
It is the lessons we can learn from the millions we have killed or injured over the ages from our certainty in the face of ignorance that can teach us and humble us the most, dash our certainty, limiting the harm we cause. It is the lessons we can learn from their deaths and needless suffering that can make us better doctors - better people.
To hell with your Hippocratic oath and its allegiance to false gods, the forbidding of abortions, and a reminder to pay your teachers - but instead swear to never succumb to certainty, false heroes, prestige, arrogance, and historical fantasy.
Remember that patient care is really no longer even the point in our academic centers, our teachers focused instead on grants, publications, and certainty, all draped in robes of arrogance and pageantry stemming from their make believe past - esteemed, grand and glorious. Can you imagine physicians who feel patient care - limiting suffering and death - beneath them? Academics are lost, and all for a sense of their own self-importance and imagined prestige, even at the price of unnecessary suffering and death and the loss of our collective humanity as providers.
Perverse, dehumanizing - this is how we train our future doctors.
I urge you, students of medicine, to focus on the harm and quackery of our past so you may feel the humility and understand the harm you may otherwise cause. Focus on the potential for harm to be caused by you and/or your teachers - and learn.
Reject certainty.
Reject prestige.
Reject false narratives and historical fantasy.
And always, always, strive to remain humble, and humane.
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