“Every hospital should have a plaque in the physicians and
students entrances –
There are some patients whom we cannot help,
There are none whom we cannot harm“
Dr Arthur Bloomfield
Science underpins a lot of what doctors do, but medical practice is largely an ill-defined art. The mix underpins the broad activities of medicine: from restoring health to rehabilitating damaged bodies; from promoting well-being to repairing malfunctioning organs; from delivering and nurturing new generations, to palliating the dying process.
In all these acts of the drama that is Medicine, there is only one intangible rule – to do no harm. Primum non nocere has fashioned the medical tradition, guiding it through centuries of a turbulent history, moulding its character, and guarding it against the challenges of each passing modernity.
The greatest challenge to this cardinal rule of Medicine is the very nature of medical practice itself. Clinical practice relies as much on anecdotal experience as it does on evidence-based research; it is as much an art of gut instincts, as it is a science of reasoned analysis. Alas, this recipe for the phenomenal success of medicine carries within it, the seeds of its greatest failings.
In this blog, I will review the macabre trade-off between ambiguous practice on one hand, and safe outcomes on the other. I will review the shortcuts and pitfalls that safeguard and threaten medical practice in equal measure. I hope you will find my exploration of this important theme enlightening.