Most people think of medicine as a science. Just think of the new medicines investigated, the CT and MRI scanners, the human genome research, the organ transplants and the list goes on and on. Still, medicine is as much an art as it is a science.
Most doctors are clinicians-that is they treat patients rather than solely participate in research. There are to be sure extensively researched guidelines for how to treat certain conditions. Yet, what these guidelines fail to recognize, is that experience- or if you will, a sixth sense of what is going on, often trumps the guidelines.
The other day I was working the emergency room when a patient arrived with symptoms of a urinary infection. He had right sided flank pain and burning on urination. He had in fact been seen by another physician, who had diagnosed him with a kidney infection and sent him home on antibiotics. All fine and good, because that is what the guidelines call for-yet there was something amiss. His pain was severe and kidney infections usually don’t cause severe pain. A kidney stone with a urinary infection could, so I ordered a scan of his belly. The findings were a rather large tumor in his left kidney, but no stone. Although a kidney tumor was not my first choice, it was on my list of possibilities.
Had I simply followed the guidelines, I might have missed that diagnosis. In this case, it would have most likely resulted in a delay rather than significant harm to the patient. Still, I have had many other cases, where I have followed my gut feeling rather than just research derived guidelines and have saved the patient’s life.
The message here is simple: Science is a great tool for physicians, but cannot replace the knowledge gained by years of experience. Researchers often conduct studies in large university hospitals, where the patient population and the health care providers caring for them are not necessarily the same as in say smaller community based hospitals. Furthermore, what happens in a petri dish does not always translate to what happens in real life. The human body is way too complex to rely on science alone.