Unlearning Certainty

The first two years, it’s all about identifying an answer. The answer.

It’s always nestled among five choices, at the bottom of  a carefully constructed paragraph that includes all the information we need.

Being a great first or second year student becomes of game of plodding through the cycle of memorization and regurgitation. Once we’re certain, we get to move on.

We learn to see medicine as a series of singular issues that require nothing more than facts and textbooks. As long as we’re smart, we come to believe we can rip through patient problems with efficiency and ease.

Fortunately, medicine is an intricate, ongoing dance between science and compassion, in which we must not only think and memorize, but also listen, engage, and connect.

Clinical care that brings patients and physicians together does not stem from box checking. It unfolds out of recognizing the limitations of certainty and the importance human-to-human trust in healing the body and the soul.

We all have the choice to stop playing the game of certainty. To opt out of regurgitating facts and anchoring ourselves to answers, and opt into engaging with those we care for. If we do that, we might get a little closer to being the kind of doctor we thought we would be when we first got our crisp, overly starched white coats.

One who refuses to rest on the appeal of being right and instead, focuses on doing right. One who constantly circles back to the uncomfortable questions of “Am I sure about this? and “What am I missing?”

Once we hit the requisite threshold of facts and physiology, making the move from good to great depends less on what we think, and more on how we think and how frequently we choose to show up with presence, attention and humility.


  1. says

    Very insightful Jack
    I’m reminded of a memorable quote by someone sharp “The illusion of certainty versus the reality of uncertainty”. It’s almost 30 years ago but feels like yesterday – that sinking feeling when all the clinical facts enthusiastically learned, empowering, (invincible even!) didn’t correlate with the patient in front of me.
    What do I accept as reality, what is superfluous to appropriate care? Thus rages the conflict between the art and science of medicine. I wish you well my friend.

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