Kenneth L Abbott, MD, FACP  |  2/6/2023

Humble Pie

About five years ago, I developed a personal tradition of beginning each new year by reading some of the classics of literature, broadly considered as including history, science, and philosophy along with literary works. Some of these books have been fun to read, others laborious, many challenging. Allowing my reading guide to make my selections for me, I have encountered some books I doubt I would have picked up on my own. At basis, the exercise has been good medicine for me, although some pills are tougher than others to swallow. And some get stuck going down.

In 2023, I have to date (among other works) read selections written by some of the great scientists and physicians of the past. Hippocrates, the ancient Greek father of medicine, wrote more than just an oath. He was a keen observer of human illness. Galen was a second-century Roman physician whose ideas, some fanciful and others remarkably right considering the handicaps under which he worked, dominated western medicine for more than a millennium, for good and for ill. William Harvey broke through in the early 17th century with an observation-based description of the circulation of the blood. It took some 30 years for the medical profession to accept his proposal over Galen’s scheme; in retrospect, one wonders what held them up so long. The only point on which Harvey stumbled was his ignorance of capillaries, the microscopic blood vessels connecting the veins and the arteries, allowing the continuous circuit of the blood. We can’t really blame him for what nobody knew.

Straying outside my comfort zone, I have also read selections from another Roman, Claudius Ptolemy, whose conception of the earth-centered universe ruled astronomy for some 1500 years, largely because it worked so well at explaining the observed motion of the sun and planets. Of course, he had to create an elaborate, complicated scheme of spheres within spheres and circles on circles, but his system could account well enough for celestial movement that ship navigators were able to get to their destinations using Ptolemaic astronomy. Then Nicholas Copernicus came along in the 16th century with his sun-centered model, an improvement on Ptolemy insofar as reality is concerned (it still needed refinement by Johannes Kepler in the 17th century; Kepler’s advantage was the invention of the telescope, which Copernicus lacked), but practically speaking not as useful as the older model. Copernicus did not survive to see his eventual vindication. Looking back now, with all the insights of modern cosmology, the sun-centered model is obvious. But most people didn’t think so at the time.

The lessons I’ve gleaned, or had reinforced, so far: Just because something works doesn’t mean it’s accurate, today’s broadly accepted “truth” is tomorrow’s laughable idiocy, and even a good idea can be improved upon. Keeps a guy humble. Nowhere is humility—a realistic idea of one’s limitations—more important than in medicine. Test everything. Keep what is good and discard what is not.

Learning is a vital human task. When we stop learning, we stop living.
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