I was at a party last night with all these Johns Hopkins oncologists. (I did not crash; I was invited. I brought apple granola as a hostess gift, even though Charlie was the one who took the afternoon off from curing cancer to make the super yummy white sauce lasagna.) But so anyway, apropos (maybe) of your last post, I got to talking to these folks, and they were really nice and humane and I liked how they talked about their kids and they were enjoying the wine, and everything like that. And then in three of these conversations it became clear, to me, that what they were casually doing was working out this argument that the practice of medicine can be largely replaced with a series of algorithms or logic shrubberies or something. That in a way the doctor doesn't even need to be present.
Which I don't dig, because it seems--as I stupidly said with my actual mouth in the first conversation rather than by tensing my shoulders or looking momentarily ceilingwards as I ought to have--like a defense of the practice of spending five minutes with a patient, locating them (the plural pronoun as a gender-neutral will prevail, so let's just practice getting over it) on the appropriate logic shrubbery and heading to the next roomlet to avoid eye-contact with the next (he or she or they, hope, still, despite waiting in this tiny room with the cross-section of the human throat and tongue and sinus emblazoned with the name of a pharmaceutical company and a copy of Red Book) patient by consulting the next chart. I'm willing to keep being patient if the doctors will keep practicing; otherwise, no. But so I said to the really nice and smart man who teaches Medical Inference--which is kind of awesome--I said, said I, that as undeniably useful as the statistical understanding of medical causality is, long may it ride, statistical understanding also seems like the cause of lots of missed or partial diagnoses, and it also seems a philosophical defense of spending only five minute with your patient because, after all, for purposes of healing they're just a set of symptoms to be divided as neatly as possible from the total set of personal phenomena.
He seemed a little hurt by that. Do I get to get hurt if someone suggests that most education is actually dyseducation? I sort of wish that people would say that to me more often. And of course I hadn't meant to be aggressive, although clearly I was a little, at this party with the multiple yummy lasagnas and the Chiantis that didn't change my mind about Chianti and the talk of children.
But so a couple things. One is that it seems like a problem if long practice and even deep competence make us skip the first step of open observation. Not scanning for the most obvious things but allowing the senses a moment of soft focus to see what might constellate in that moment: maybe something orbiting around something else in a wholly unexpected way. Maybe the answer to a question one hadn't even consciously framed. Number two is this: we're basically herd animals, and although it's hard to see, we spend a ton of time and energy achieving consensus. We're pushing each other around or running the personal edition of the deep-consensus software all the freeriggin' time. The fact that I can't spell consensus but change it when the spellcheck thingy tells me to is the tip of the assberg. (There goes my neighbor Rob in dad jeans. These are not the right jeans. And so forth. Serious, those jeans don't look good, and his hat is pulled own too far, and what's he going to do with that folding chair?) These good people were standing around at the nice party telling me politely to believe a particular thing about the medical product I'm supposed to gratefully buy.
So much militates against the sort of openness you're describing. But I think that something like What Is Perceptible When You're More Open to Data That You've Ever Been Before is my version of God at the moment.
So I never got to Wichita Mind Control. It was Bruce Conner's phrase for the feeling when he first sat listening to Harry Smith's deeply weird and centripetal Anthology of American Folk Music in the Wichita public library. For the first time, he said, " I was sure something was going on in the country besides Wichita mind control.” Statistically, in some distant galaxy a Sophia Lauren who will never leave Rome is making an unheard-of type of lasagna with a vegetable that tastes like chlorophyll butter and the smell of ambergris. A 14 year-old Keith Richards is fiddling with the dial of his radio at 2AM to hear Muddy Waters through the staticky surf of G.I. radio. And a doctor is sitting down to an excellent meal in expectation of a two hour conversation during which he will seldom speak.
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