finding the medical middle
In my experience, doctors are quite capable of looking at a medical dilemma from multiple angles. While we ultimately strive to practice standard-of-care medicine, we have no trouble acknowledging flaws in our evidence or reasoning. This is to say nothing of the cynical streak that runs through the profession. What is gallows humor if not a morbid form of equanimity?
There are medical extremists out there. Most are true-believers driven by a desire to reshape practice; a few have financial conflicts hanging over them. I probably sit on the edge of the discourse on a couple of important issues. These days, however, my most extreme views concern the formatting of pathology reports. I’ve grown tired of proselytizing, and I’m better off for it. There is an expansive, curious middle to explore.
Some interesting reads on finding balance…
The Power and Peril of the ICU - The Baffler, Adam Gaffney
“Today, decades after their proliferation across the globe began, the United States has more ICUs per capita than almost anywhere else on Earth. Notably, that supply came in use during this pandemic: without it, our death toll from Covid-19 may have been even more abysmal than it is. But outside the context of a pandemic, too often that overabundance has influenced the ways that care is delivered.”
Covid-19: Gabriel Leung reflects on Hong Kong’s devastating fifth wave - The BMJ, Mun-Keat Looi
“We’re now not anywhere near zero covid but at a fairly steady equilibrium phase—you have waxing and waning of case numbers just above or just at a sort of unitary threshold. That tells you that the hybrid immunity wall built up since the fifth wave hit at the beginning of this year has held up fairly well. And like most of the world, I think that we’re now transitioning into an endemic phase where we are all going to have to learn to live with the virus.”
A tweet before dying - WIRED, Paul Ford
“R.I.P. the revolutionary internet, 1997–2022. I’m grieving a little over here. But life must go on, despite who wins the US midterm elections, who owns Twitter, and how ridiculous the metaverse might be. That’s why every morning, sometimes before breakfast, when I am in despair, I remember the three letters that always bring me comfort: PDF. And then, when I can, I go digging. I read about Gato, a new artificially intelligent agent that can caption images and play games, or the mathematics underlying misinformation, or “digital twins,” which are simulations of real-world things like cities that consulting firms seem able to sell these days. One site, scholar.archive.org, has PDFs going back to the 18th century. It’s empowering to look for this stuff instead of waiting for it to be socially discovered and jammed into my brain.”
Battle of the Experts: The Strange Career of Meta-Expertise - SSRN, Frank Pasquale
The very concept of meta-expertise confounds traditional distinctions between elite and democratic power. On the one hand, the meta-expert seems to suffer from all the debilities of the traditional expert, only more so. Whereas a traditional expert at least has a bounded set of situations to claim to be knowledgeable about, the meta-expert asserts expansive intellectual authority. On the other hand, skeptics of professions (as well as professional skeptics) claim that experts’ authority must have some substantive (and not merely democratic and procedural) limits. These skeptics tend to see the meta-expert as a powerful “tribune of the people,” capable of vindicating both common sense and counterintuitive findings in the face of guildish lethargy and incuriosity.
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