Kathryn’s Response of Montgomery   1 comment

I very much enjoyed the way that Montgomery tackled the issue of public perception of medicine as a science and doctors as scientists, which is of course not the full picture. The way that doctors themselves, even those from more social science backgrounds, maintained a concept of medicine as a science even if they were not 100% scientists but rather practitioners of something that was part science part art.

As a composition instructor, like Montgomery addressed in chapter 3, I think that not only the narratives of the patients are important, but what is practiced and valued in medical writing. On page 49 Montgomery says “the clinical case history not only provides a means of working out and remember what is best to do for a give patient, but also captures experience and presents it to its audience. As a result, case narrative is the primary, vicarious means of shaping clinical judgment for new learners and experienced practitioners alike.” What this calls attention to is how clearly narrative experience is tied into the practice of scholarly medical publishing that furthers the development of medicine. Even tests and publications of new drugs or procedures are only put in a clinical, medical setting very late in the game. And while this is partly about getting a wider sample of results before the start of general distribution, it is also about getting to understand the experimental treatment in context with a more diverse swath of patients.

At least it should be. This is what doctors want from a clinical trial, while companies are more interested in reproducing the lab results to build support and confidence in their product. I suspect that we might be more skeptical of our science mingling too closely with our medicine, but speculations like that could be a whole post in itself.

The ideal behind clinical judgment, as developed over a long apprenticeship, makes me feel a little more confident about medicine in general, but as Montgomery is often pointing out, this bears far more resemblance to a social science then the universally reproducible results of physics, to paraphrase from page 71. So like the story of the boy building the card tower, medicine is rigorous and rational, but it is not possible to isolate the individual factors that go into a medical condition.

Because I’m a child of the electronic generation, I tend to like to have the tv on as I do work. This Saturday, while cleaning, I had on a House marathon. I do try to catch the episodes when they’re on, but I’d always considered them ridiculously inaccurate. I still believe that, but now for slightly different reasons. The odd, intuitive causalities that the titular character pulls from seemingly nowhere, I thought were the ridiculous. That, as Montgomery is getting at, is an important part of medicine, though one that is not fully celebrated among the public or the medical community. Montgomery mentions Sherlock Homes and deduction at the start of chapter 6, indicating that doctors have taken deduction as a descriptor of what they do. That the main character of House is based of Sherlock Holmes seems to be an interesting connection. One that might indicate that the absurd seeming medical show may have a bit more to do with medical thinking then I initially though.

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Posted August 31, 2010 by kathryndunlap in Uncategorized

One response to “Kathryn’s Response of Montgomery

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  1. Cool–maybe we can talk about House tonight.

    Interesting that you connect clinical judgment to social science. I was thinking more like rhetoric.

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