Heroes Not Zombies

This little ice crystal mesmerises me. It’s beautiful. Look at the intricate branching structure of each little bristle of ice. It’s almost like a tiny tree, or, at least a snowy leaf. Look at the way it catches the sunlight and sparkles like a jewel. But maybe the most astonishing thing about it is how it is attached to the iron bar from which it is hanging. Can you see? There is a single icy spike holding the entire structure onto the metal. In an instant you can see that this little piece of frozen water is not only incredibly strong, but that the entire crystal has grown from that single point. Isn’t that amazing?

What I love about something like this is that no matter how much you describe water and its behaviour in cold temperatures, the singular, the actual, the specific, particular ice crystal you encounter takes you beyond the limits of your expectations.

I find that everywhere in life, but, especially so in the practice of Medicine. No matter how much general knowledge I had of diseases, their origins, their life histories, and their likely consequences, I never had enough to know precisely what this individual patient today was experiencing, nor how this disease had arisen in their particular life, nor how their illness would progress. On top of that, no matter how much general knowledge I had of therapeutics, I could not predict, with 100% accuracy, what this individual patient would experience as a result of what I was going to prescribe today.

You might say that sounds like a lot of uncertainty, and I guess it is. A GP’s job, after all, has been described as dependent on his or her ability to cope with, and manage, uncertainty. But there was nothing to despair in there. It was a simple recognition that we have to be humble, because there is always more we don’t know, than there is that we know.

More than that…..it meant, and continues to mean, that the individual can never be encountered, understood and helped as a mere example of the recorded experience of groups. That’s another way of saying that statistics are never sufficient to replace stories. Only this unique, singular human being can tell you what they experiencing, what has happened in their life, what sense they have made of it, and only this unique, singular human being can tell you what effect your treatment has had.

The singular can never be replaced by the averages or “norms”.