Pulitzer Prize-winning author and one of the world's premiere cancer researchers Siddhartha Mukherjee investigates in his new book the most perplexing and illuminating cases of his career, which ultimately led him to identify three principles that govern modern medicine.
The Laws of Medicine: Field Notes from an Uncertain Science, part of TED Books and published by Simon & Schuster, is brimmed with historical details and modern medical wonders and provides a glimpse into the struggles and Eureka! moments that people outside of the medical profession rarely see. The book has stories of real people and cases, diagnoses and trials.
Mukherjee's first law is: "A strong intuition is much more powerful than a weal test." His second law says, "Normals teach us rules, outliers teach us laws," while his third law states: "For every perfect medical experiment, there is a perfect human bias."
He says that understanding the little-known principles that govern medicine can empower us all.
The Laws of Medicine: Field Notes from an Uncertain Science is about information, imperfection, uncertainty, and the future of medicine, says the author.
"The 'laws of medicine', as I describe them in the book, are really laws of uncertainty, imprecision, and incompleteness. They apply equally to all disciplines of knowledge where these forces come into play. They are the laws of imperfection," he says.
According to Mukherjee, his medical education had taught him plenty of facts, but little about the spaces that live between facts.
"I could write a thesis on the physiology of vision. But I had no way to look through the fabric of confabulation spun by a man with severe lung disease who was prescribed 'home oxygen', but gave a false address out of embarrassment because he had no 'home'," he writes.
He also says that he had never expected medicine to be such a lawless, uncertain world.
"I wondered if the compulsive naming of parts, diseases, and chemical reactions – frenulum, otitis, glycolysis – was a mechanism invented by doctors to defend themselves against a largely unknowable sphere of knowledge. The profusion of facts obscured a deeper and more significant problem: the reconciliation between knowledge and clinical wisdom."
He says his book began as a means for him to discover tools that might guide him through reconciliation between these two spheres of knowledge.
Over a decade ago, when Mukherjee was a young, exhausted, and isolated medical resident, he discovered a book that would forever change the way he understood the medical profession.
The book, The Youngest Science, forced him to ask himself an urgent, fundamental question: Is medicine a "science"?
Sciences must have laws - statements of truth based on repeated experiments that describe some universal attribute of nature. But does medicine have laws like other sciences?
Mukherjee, an assistant professor of medicine at Columbia University and a staff cancer physician at Columbia University Medical Centre, has spent his career pondering this question - a question that would ultimately produce some of most serious thinking he would do around the tenets of his discipline - culminating in The Laws of Medicine.
His The Emperor of All Maladies: A Biography of Cancer , won him the Pulitzer Prize in general nonfiction in 2011.