Thursday, January 7, 2010

The Need for Certainty

A psychiatrist friend of mine said that the measure of maturity of a person was their ability to deal with uncertainty. I think there is some truth in this assertion. If, as a physician you promise certainty to a patient, it may be consoling but you are probably stretching the truth! Some physicians, now a days, give patients such a long and exhaustive list of possible complications that they frighten them to death, in order to cover their own ass. Some offer alternatives of treatment to patients who aren't really equipped to make such a decision . An abrogation of responsibility I believe. Hippocrates, the Father of Medicine , said in his book of Aphorisms, "cure occasionally, comfort always." We have a lot more tools to cure now than we had in 400 B.C. but it still applies. You can comfort a patient without lying, outline risks without frightening them to death, and can admit that you aren't always certain, but are prepared to offer the course of action you recommend.
And yet, many people are attracted to the dogmatic amongst us because of the strong certainty that they appear to provide. Down deep everybody knows we take one step at the time in the dark and despite someone holding your hand, they are also taking one step in the dark. Life has no guarantees. My friend and colleague was a very careful man in many ways. I used to kid him that he always kept his trousers up with both a belt and suspenders. If you never take a chance, avoid risk at all cost, you will probably miss opportunities. I suppose there needs to be an ability to handle some tension and anxiety and have a clear alternative exit strategy. There needs to be intelligent risk assessment. Having done that, you then must then, "go for it ". Dealing with uncertainty is not for control freaks!

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