These days, many smart undergrad students with a high GPA have a desire to go to medical school. Sometimes, I feel sorry for them. I agree that some students are a good fit for the position of a doctor in helping sick patients. On the other hand, it appears that many of them take this path because they have been told by friends, parents or teachers, that this is the best secure and successful path for “smart” students. I have no doubt about the importance of the medical doctor; however, this trend makes me ponder if a physician is really the best job option for an intelligent and creative student.
For many students, medicine and science appear to be quite similar disciplines. Both rely on observations, particularly on reproducible observations. Medicine places more emphasis on correlations between reproducible observations, whereas science focuses on the cause-consequence relationships between them. Therefore, reproducibility is particularly essential in science. In other words, THE only matter in science is reproducibility. If something is not reproducible, it cannot be handled in science. To guarantee the reproducibility, scientists need to define all factors that could potentially impact the outcomes such as pre-existing conditions, reaction conditions and the methods of detection and analysis. We often refer to this whole process as an experiment, which regardless of whenever and wherever it is conducted and whoever it is conducted by, should yield the same results. This perspective also facilitates reductionism, as the reduced system is easier to control, understand and reproduce. On the other hand, how the results are interpreted is totally up to us. It is often influenced by the perspective at the given time and place or the bias of the scientists who performed the experiment. Importantly, whatever the interpretation is, the results need to be reproducible.
Medicine is fundamentally different from science. From the infancy of medicine, practitioners focus on correlations. Careful observations of patients permit diagnosis (or categorization) and provide treatment options. This procedure is reasonably reproducible within limited areas and time as similar symptoms are caused by similar local etiology, but is not necessarily universally adaptable. In modern medicine, some scientific approaches are implemented to identify and analyze the causal effects within those correlations. However, due to the nature of medicine, it is impossible and not necessarily appropriate to fully adopt scientific approaches to all aspects of medicine. Technological innovations in sequencing and detection of traces of molecules allowed for the discovery of new correlations that were previously not recognized. This led to the sub-classification of a disease that was originally thought to be a single disease and so on. In some cases, we could find clear cause-consequence relationships like a causative gene for a heritable genetic syndrome. However, these would be rare examples. In reality, human physiology is more complex and interactive with the environment, and the simple adding-up of reductional results does not give us a comprehensive understanding of the diseases. Thus, in medicine, we always need to keep holistic views that are not necessarily aligned well with science.
I believe that we, humans, are the only species that conceive the intangible perception of time. We use calendars and clocks to visualize something invisible. Foreseeing and envisioning are unique abilities of humans, in contrast to the short-term predictions used by many animal species for hunting and escaping. On the other hand, this future cognition ability causes anxiety that is an emotion to the future, in addition to fear that is a sense to current dangers. In the ancient era, fortune tellers were essential for guiding a pack, village or even a nation. This role has gradually been replaced by religion and God, as people use faith to deny uncertainty. Then by modernization, the field of science emerged, with the reproducibility mentioned above allowing us to make correct predictions. Those predictions are tightly linked to cause-consequence relationships, unlike the signs of correlations used in previous times. Now, people have simply replaced the roles of fortune tellers with scientists, although they have no idea how scientific predictions are made and what they are based on. Ironically, this blinded belief in scientific predictions and interpretations is now also causing distrust and doubt towards science.
Scientific approaches and science are two different things. Scientific approaches have been proven to be very useful even in non-science areas such as medicine, sociology, psychology and so on. In these disciplines, scientific approaches refer to the reproducible procedures, but not reproducible results as it is impossible to control the pre-existing conditions in these cases. Evolution and geology are also fields in which we cannot exactly reproduce results, but scientific approaches have been proven to be useful for understanding the potential mechanisms behind them. However, because it is impossible to define all conditions potentially impacting the outcomes, their predictability and validity in a real context are always compromised. In the end, that is why they form the different disciplines.
I have always been amazed by mathematics. I have no idea how mathematicians come up new ideas. Once they prove something new, their discoveries are context-independent and allow us to move forward irreversibly. On the other hand, science is dealing with the real world and thus is all context-dependent. We, as scientists, try to define all conceivable conditions, yet something unconceivable is hidden. Then, when someone discovers that, the dogma needs to be re-established. This often happens with new technology. Once something unconceivable is recognized, we conceive it with new words to reconceptualize the world around us. Amazing imagination! Science is a creative activity, not so different from other creative activities such as arts, music and literature.
Acknowledgement: I thank Lily Sul for English editing.
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