Three errors outlined by David Wootton in his very excellent book Bad Medicine:
1. We ignore non-events:
What we need in cases such as these is a history, not of progress, but of delay; not of events, but of non-events; not of inflexible logic but of a sloppy logic, not of overdetermination, but of underdetermination.
Because we have not listened out for the screams, we never hear the eerie silence that fell over operating tables in the 1850s.
Since this book argues that real medicine begins with germ theory, at its heart there is a most puzzling historical non-event: the long delay that took place between the discovery of germs and the triumph of germ theory.
2. Knowledge and therapy are together in hindsight, but separate in reality:
We tend to assume that where there is progress in knowledge there is progress in therapy… but before 1865 progress in knowledge rarely led to improvements in therapy.
Between the sixteenth and the nineteenth centuries, ideas about the body changed fundamentally, but therapies changed very little. Bloodletting was the main medical therapy in 1500, 1800, and 1850. The discovery of the circulation of the blood (1628), of oxygen (1775), of the role of haemoglobin (1862) made no difference; the discoveries were adapted to the therapy rather than vice versa.
Harvey announced that the heart pumped blood through the arteries in 1628; yet the use of the tourniquet in in amputations, which one would have thought was an absolutely elementary application of Harvey’s theory, was first pioneered by Jean Louis Petit (1674-1750), roughly a century later. Leeuwenhoek saw what we would now loosely call germs, or more accurately bacteria, through his microscope in 1677; yet in 1820 microscopes had no place in medical research, and in 1881 the conflict between germ theorists and their opponents was only just entering its final phase. Penicillin was first discovered not in 1941 but in 1872. And so on.
3. Status quo and confirmation errors plagued the progress of medicine:
To think about progress, you must first understand what stands in the way of progress–in this case, the surgeon’s pride in his work, his professional training, his expertise, his sense of who he is… the obstacle was the surgeon’s own image of themselves.
In the late 18th century, something strange occurred: a revolution in medicine that should have happened did not.
It started in 1772, when Joseph Priestley, an English theologian, philosopher and chemist, synthesized nitrous oxide. The compound followed two very different trajectories. Within the scientific community, a few researchers followed up on Priestley’s discovery. One, Humphry Davy, noted that nitrous oxide “appears capable of destroying physical pain” and recommended that “it may probably be used with advantage during surgical operations.” The British upper class had a different idea. The laugh-inducing compound became a popular recreational drug; laughing gas parties were commonplace. Yet for nearly half a century, Davy’s suggestion was ignored. Not one doctor—or any of those giggling British aristocrats—thought of using nitrous oxide to dull the pain elicited by surgery. Thousands suffered in vain.
That changed in 1845 when a dentist and surgeons from Boston connected the dots. On October 16th, 1846, a team of surgeons administered an anesthetic gas to remove a larger tumor from a woman. She experienced no pain, survived, and modern anesthetics were born. “Gentle, this is no humbug,” declared John C. Warren, a dentist at the Massachusetts General hospital.
It’s difficult to ignore near-misses in history. In his early teens, Blaise Pascal constructed the first mechanical calculator, ideal for a 17th century accountant, yet ignored for 250 years. Mendel’s famous pea experiments were overlooked for decades after his death. Sanctorius Sanctorius invented the thermometer in the 17th century, but it did not become a standard tool for clinicians until the mod 19th century. Davy saw the benefits of nitrous oxide, but doctors ignored him. Why?
To think about progress, you must first understand what stands in the way of progress.
A good aphorism ignites the mind more than classroom learning, and in a fraction of the time.
The true altruist would never be ashamed to reveal his motives; his insincere counterpart, the opposite.
Nothing prevents us from being natural as much as the attempt to be natural.
Avoid italicizing to make your point; self-discovery is the most powerful form of learning.
One of the most enduring themes of creativity is that it clusters. Think Elizabethan England, ancient Athens, Silicon Valley, and Renaissance-era Florence. People with good ideas are attracted to each other.
In a 2005 interview with Dan Pink, Thomas Friedman, author of The World is Flat, argued that “Several technological and political forces have converged, and that has produced a global, Web-enabled playing field that allows for multiple forms of collaboration without regard to geography or distance – or soon, even language.” Yet at least with respect to collaboration, Friedman has it backward. The world is not getting flatter—we’re clustering.
Consider this. In 2010, Isaac Kohane and colleagues discovered a correlation between the quality of academic papers (as measured by the number of citations it had) and the geographic location of the authors. The closer together the co-authors lived, the better the research. A recent paper by Stefan Hennemann and two collaborators who examined scientific collaboration likewise found that across “six distinct scientific fields… intra-country collaboration is about 10–50 times more likely to occur than international collaboration.” As Edward Glaeser notes in his book Triumph of the City, “Cities speed innovation by connecting their smart inhabitants to each other… proximity makes it easier to exchange ideas or goods.”
Years ago—around the time The World is Flat was published—commentators were predicting the demise of cities as cheap communication was flourishing. With Skype, why would anyone need to commute? Yet at no other point in the history of the United States have more people flocked to cities. For the creative class, at least, the ideating mind craves collaboration and abhors the suburban and rural vacuum. And as the cost of living in a city like New York or London increases, the barriers to entry are strengthening, not crumbling.
The attempt to conceal an insecurity usually reveals an insecurity. In life, only those trying to lose a few pounds announce, without prompt, how many miles they ran, just as only miserable single people announce, without prompt, how much they love being single.
The more reasons I invent to justify something the more I known to avoid it, just as I know to avoid meetings with many people, but not few.