The Laws of Medicine, written by Dr. Siddhartha Mukherjee, comes as an easy to understand essay but leaves you with a profound impression of both the content and its writer- what in my opinion qualifies to be Magic!
In the very first few pages, the book serves you with what it is going to offer. Unlike what you may presume from its title- The Laws of Medicine; the book doesn’t elaborate the laws of the medical field, it rather, tells you about the laws of uncertainty, impression, and completeness- inherent and prevalent in this field. This book can change your perception of your doctors and care givers.
As Siddhartha Mukherjee states in his book, “Laws are statements of truth based on repeated experimental observations that describe some universal or generable attributes of nature”. Physics for example, has many laws; chemistry has lesser and biology seems to be lawless. Living creatures have been living with laws of physics and chemistry, converting forms of energy and sustaining their existence. We all have been taught that fundamental laws of nature govern matter and everything around us.
The obvious question that boggles our mind then is- if medicine too, is governed by universal guiding principles that lead into truth that applies to medicine at large. To our rescue comes Dr. Siddhartha Mukherjee, who offers a set of laws of medicine- that invigorate that there are, in fact, no laws in the literal sense. He puts together many examples and personal experiences to convince you that you have been thinking of medicine totally differently. Your perception of medicine as a field is set to take a U-turn.
Following are his three laws of medicine.
Law 1: A strong intuition is much more powerful than a weak test.
Dr. Siddhartha Mukherjee discovered this law by chance, through his own personal experience. He says, sometimes symptoms direct the doctor to order tests that are unrelated to the patient’s ailment. In such situations, intuition and observation become powerful tools to guide the doctor to look for the correct diagnosis, distinguish false positive and false negative test results- that would otherwise be missed in the absence of intuition.
Law 2: ‘Normals’ teach us rules; ‘outliers’ teach us laws.
Every outlier or non-normal patient offers the doctors with an opportunity to refine prior knowledge and challenge preconceived notions about an ailment and its management. Outliers provide new pieces of information that revamp any discipline and help discover its hidden inner logic.
Law 3: For every perfect medical experiment, there is a perfect human bias.
I loved this sentence. The reason for bias in medicine is “Hope”, and the solution is randomization and blinding.
He states that the uncertainty in medicine is not limited to these three laws; there could be, more laws, yet to be found and stated. He has framed his three laws based on his personal experience during his medical internship, residency, and fellowship.
I was moved by how he concluded his essay. He quoted Voltaire, “Doctors are men who prescribe drugs of which they know little, to cure diseases of which they know less, to human beings of whom they know nothing”. He says, “The pivotal word remains- to know”.
This book is a published version of his TED talk, but is equally pleasurable to read. This micro book that looks like a handout, leaves you with visuals of doctors in your head, whom you have visited in your lifetime- in pain or in doubt.
It’s a kick-start for those planning to plunge themselves into science writing and communication. So, go for it!
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