MARCH 14, 2024
Originally published by our sister publication General Surgery News
To the Editor:
I recently took my grandchildren to their ballet practice. I must admit, despite years of financing my children’s dance adventures, I still am not completely sure of the difference between first position and first base. Being completely out of my element and looking for a “port in the storm,” I settled into a chair near an officious-looking woman who turned out to be a Harvard-educated professor
Originally published by our sister publication General Surgery News
To the Editor:
I recently took my grandchildren to their ballet practice. I must admit, despite years of financing my children’s dance adventures, I still am not completely sure of the difference between first position and first base. Being completely out of my element and looking for a “port in the storm,” I settled into a chair near an officious-looking woman who turned out to be a Harvard-educated professor and the chair of the information technology department of the local university specializing in artificial intelligence. Lacking even the most basic knowledge of AI, I spent the next hour engaged in a fascinating conversation.
She told me of the incredible power of this tool, the breathtaking speed of its ongoing evolution, its increasingly remarkable ability to self-educate and the coming transformative effects it will have on our society. She proclaimed that within the next five years, this tool will transform every facet of the way we live, work, travel, educate and entertain ourselves. She went on to say that in the next decade, the practice of medicine will become unrecognizable due to the immense increase in the amount of data available as well as the technologies’ future ability to analyze and institute treatment. She described a type of epochal Schumpeterian “creative destruction” on our profession, heretofore never witnessed in the history of the art.
The power, speed and resultant transformative changes to come from these technologies is well described in Thomas Siebel’s book “Digital Transformation.” Big Data and AI will certainly provide powerful new tools that will hopefully allow us to significantly innovate and improve our clinical care and research capabilities. However, as we ineluctably become more and more reliant on these technologies, I believe we must guard ourselves from becoming impersonal interfaces between the patient, the data and the machines. As T.S. Eliot so presciently stated in his poem “The Rock”: “Where is the wisdom we have lost in knowledge?” We cannot lose sight of this important concept.
Accordingly, we must remember that patients disappointingly often do not follow the predictable laws of science. They are each independent and unique laboratories markedly impacted by the forces of human nature and the societal milieu around them. I tell the residents that data and science are great, but you can do the exact same operation on three very similar patients and get an array of differing results. That is the human nature element and the understanding of which is the hallmark of the compassionate and successful physician.
As we can’t reliably predict how these transformative information and interpretive systems will affect our profession, the preparation for their future integration will probably be guesswork and done on the fly. But what we can do is to reemphasize the importance of the essential understanding of human nature in order to allow us to best shepherd our patients through this upcoming new world of technomedicine. These skills are best learned through personal experiences and by an extensive exposure to a broad liberal arts education. It has been shown that the exposure to literature (particularly fiction), poetry, creative writing, art and music are essential to understanding the complexities of human nature. Also, a strong exposure to the humanities has been shown to enhance one’s ability for analytical interpretive thought (Einstein’s definition of a true education), communicative skills, group cooperation as well as the critically needed facility of adaptability to change.
Currently, our pre-medical school curriculum is too skewed toward the hard sciences and insufficiently weighted to the humanities, liberal arts and personal development experiences. This needs to change if we are going to train competent future physicians instead of technocrats in this data- and technology-driven world. I remember many times during my practice dealing with some offensive misdeed of a patient in need of care by thinking back to the first paragraph of “Moby Dick,” in which Herman Melville profoundly states: “There is a beast in every man.” This often allowed me to settle down, gain some balance and perspective, and provide effective and compassionate care. No machine can do this! So, for me, I think I will take in more ballet!
—James K. Elsey, MD, FACS, is a professor of surgery at the Medical University of South Carolina and a past vice chair of the Board of Regents of the American College of Surgeons.
