Wednesday, December 17, 2008

Translating clinical knowledge into wisdom

I would like to share another quote from Osler (also contextualized in another paper in the same issue of the Journal with Carmel and Achim as co authors):

http://www.ingentaconnect.com/content/bsc/jecp/2008/00000014/00000005/art00021

"Carry a small note-book, and never ask a new patient a question without note-book and pencil in hand...Begin early to make a three-fold category - clear cases, doubtful cases and mistakes. And learn to play the game fair, no self-deception, no shrinking from the truth; mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch. It is only by getting your cases grouped in this way that you can make any real progress in your post-collegiate education; only in this way you gain wisdom with experience."(Osler 1904, 1928)

Another definition of Knowledge and wisdom comes from Information theory:

Knowledge is information that can be easily recalled ( Imagine a very knowledgeable person who expounds volumes on a particular topic that may be vaguely related to the query you have posed but hardly goes anywhere near answering it). Even google is quite knowledgeable that way and can even often answer our queries after giving us a lot of information options to choose from.

Wisdom is in being able to apply knowledge in a manner that answers our queries with minimum noise or redundancy in the information conveyed. This off course just remains a human trait for now, I am not sure how long though.

I am very interested in clinical problem solving exercises (which you mentioned about your student) that would apply a patient centered stance rather than the disease based stance that we are compelled to publish as case reports.

I wonder when we shall get a case reports journal which would include patient's perspectives as well and not just talk on the disease. This may have come out in isolated snippets as the patient's journey in BMJ but its time we had a complete journal devoted to it.

Or better still an open access online data base that keeps getting regularly updated...Or why not conate/collate already accumulated patient health professional experiences available on the net to help solve our clinical problems in a patient centered manner on a regular basis? ( this is probably the bottom line in the other paper with Carmel and Achim in the same issue of the journal)

1 comment:

Anne Marie said...

Rakesh,
Congratulations on the publication. I just came across it this evening and will have a good read in the next few days.
I think this kind of discussion is going to be with us throughout a lot the next few years.
Have you seen this?
http://scienceroll.com/2008/12/08/tripanswers-or-twitter/
Best wishes,
Anne Marie