Tuesday, September 5, 2017
Book Review: 'The Laws of Medicine' by Siddhartha Mukherjee
Dr. Siddhartha Mukherjee is a brilliant oncologist whose book, "The Emperor of All Maladies: A Biography of Cancer," won the Pulitzer Prize for nonfiction. In this slim volume, the author discusses what he considers to be the essential principles of medicine: 1. A strong intuition is much more powerful than a weak test. 2. "Normals" teach us rules; "outliers" teach us laws. 3. "For every perfect medical experiment, there is a perfect human bias."
Dr. Mukherjee believes that having information at your fingertips is useless unless it is paired with "clinical wisdom." To help his students, he has developed "guiding rules that a young doctor might teach himself as he navigates a profession that seems, at first glance, overwhelming unnavigable." The author presents interesting anecdotes, not just from his practice but also from the history of astronomy, citing how scientific opinions about planetary motion evolved over time. In addition, he quotes the work of Lewis Thomas and explores the ideas of Thomas Bayes, an early eighteenth century clergyman and philosopher. Mukherjee, a cogent, persuasive, and thought-provoking writer, insists that modern medicine is not an exact science. A competent physician must pay close attention to a patient's appearance, speech, and of course, his family and medical history. In addition, a proficient doctor draws on extensive experience, the laws of probability, and his "gut instinct" to solve medical mysteries. When a patient is ill, but conventional testing does not reveal the cause, savvy practitioners will look for subtle clues to assist them in making the correct diagnosis.
"The Laws of Medicine" is an entertaining, enlightening, and provocative look at how imagination, creativity, and medicine converge. It is vital to realize that patients may lie or withhold key facts; that there is much to be gained from studying "outliers," (those who do not fit the norm); and that we have a tendency to allow preconceived notions to warp our judgment. A little humility goes a long way in health care as in life.
Editor's note: This review was written by Eleanor Bukowsky and has been reposted with permission. Like what you read? Subscribe to the SFRB's free daily email notice so you can be up-to-date on our latest articles. Scroll up this page to the sign-up field on your right