Granting the etymology, medicine is clearly an art, defined as "a set of understandings and actions which are based on education and experience and for which the practitioner cannot bring to consciousness the reasons" as well as a science. Norretranders' book, cited below, provides a cogent review of the evidence for this postition.
Norretranders, T. (1991). The User Illusion: Cutting Consciousness Down to Size. New York, Penguin.
Norretranders notes the well-documented fact that our sense perceptors can process upwards of ten million bits of information per second, while consciousness can process 16 (or perhaps a maximum of 32) bits per second. 150
"We do not experience the world as raw data. When our consciousness experiences the world, the unconscious discarding of sensory information has long since interpreted things for us.
What we experience has acquired meaning before we become conscious of it." 187
"We experience not the raw sensory data but a simulation of them. The simulation of our sensory experiences is a hypothesis about reality. This simulation is what we experience. We do not experience things themselves. We sense them. We do not experience the sensation. We experience the simulation of the sensation.
This view involves a very far-reaching assertion: What we experience directly is an illusion, which presents interpreted data as if they were raw. It is this illusion that is the core of consciousness: the world experienced in a meaningful, interpreted way.
Why do we not merely experience what we sense? Because we sense far too much, millions of bits a second. We experience only a fraction of what we sense--namely, the fraction that makes sense in the context." 289
[Then one difference between an expert and a novice is that while the sensory data they receive may be identical, their conscious experience will be significantly different--because their simulations of the sensory data will be constructed according to different rules of meaning and context. Thus much of an expert's reasoning is inaccessible to consciousness or accessible only with considerable thought--part of the reason why good teaching is hard cognitive work. It also may explain why many experts are unable to understand the complexity of the information-processing task faced by the less expert; to experts their simulation of the sensation appears to be simple, unprocessed data, available for all to see. JMW]
Jim
The early bird gets the worm, but the second mouse gets the cheese.
James M. Walker, M.D.
Chief Medical Information Officer
Geisinger Health System
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>>> "Prof. Robra" <[log in to unmask]> 10/07/02 03:05PM >>>
>
>
> Interesting article.
> Amit Ghosh
>
indeed.
And I wonder where the misconception "medicine as an art and a science"
originates from? What the good old Romans termed "art" ("ars") was their
translation of the Greek word "techne". Even if you don t happen to be
familiar with classical Greek, you will recognize the root. This word
can for instance be found in the Hippocratic oath indicating "the rules
of medicine". Techne is something which can be be taught and learnt,
quite distinct form intuition. Perhaps someone can explain the "truism?"
further? We d probably better stop misconceiving medicine for an "art".
> every
> medical student is drilled with this truism: ''Medicine is
> both an art and a science.'' The ''art'' is represented to
> be the physician's intuitive sense of a patient and her
> underlying diagnoses and how she might respond to certain
> treatments.
Best wishes, Peter
--
Prof. Dr. med. B.-P. Robra, M.P.H.
Institut fuer Sozialmedizin und Gesundheitsoekonomie
OvG-Universitaet Magdeburg
Leipziger Str. 44
D-39120 Magdeburg
Email: [log in to unmask]
URL: http://www.med.uni-magdeburg.de/fme/institute/ismhe
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