A key form of medical intelligence cannot be manufactured in a laboratory, bought by pharmaceutical companies, or fully captured in a randomized controlled trial. It develops through years of observing patients, recognizing patterns, listening deeply, making mistakes, and learning from the extraordinary complexity of human suffering. We call it clinical intelligence, and modern medicine risks sacrificing it on the altar of statistical authority.
One of my favorite doctors, Pierre Kory, MD, had the words INSUFFICIENT EVIDENCE tattooed on his arm. The words insufficient evidence can become a convenient way to dismiss common sense, clinical experience, and even the suffering of the patient standing before us. Behind these two words, scientific uncertainty can become an excuse for intellectual arrogance.
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