"The greatest obstacle to discovery is not ignorance - it is the illusion of knowledge."
-Daniel J. Boorstin
myopia: lack of foresight or discernment; obtuseness; narrow-mindedness; intolerance
To be a doctor is to be constantly on guard against a sea of troubles, always keeping an eye out for dark clouds roiling on the horizon. Patients are fairly good at providing clues as to who or what has invaded their sanctum sanctorum. It is then up to doctors to reveal the intruder's identity and come up with a plan to eradicate him. Physicians harboring personality quirks, undiagnosed neuroses or simply bad attitudes may fail in their mission, sometimes by unfairly comparing the symptoms of the patient with their own heart-rending complaints, sometimes by exhibiting a mystifying talent for overlooking the obvious, almost as if they are afraid to learn the truth which might of course lead to more work. The easy way to get through the day is to avoid conflicts, like a ship's captain who knocks down the crow's nest, saying "We're sailing straight through and not looking for trouble."
As you can surmise, the problem with such reasoning is trouble is more than happy to come looking for you. I remember one time during my residency when I was asked to see a patient complaining of chest pain. It was late and I recall looking at an x-ray, but that was about the extent of my evaluation. The patient eventually settled in and so did I - until the next morning when on rounds my attending held up that same film like Ramses the Great in his court, revealing to all gods and mortals in attendance the pneumothorax I had failed to recognize. I felt like a small white bull lying supine upon some ebony altar.
Over the years I have learned that it doesn't require a genius I. Q. to be a good doctor, but it does require a mastery of a certain je ne sais quoi that the poet e. e. cummings described best:
(now the ears of my ears awake and
now the eyes of my eyes are opened)
Next, The Five Deadly Sins of Doctors, Part IV: Nihilism
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My first doctor thought that I had done such a wonderful job of dx myself (O, the dangers of the Internet) that he simply agreed with my dx, enough so that he did not even order a chest X ray (I had pleurisy) or take the time to do a physical exam. (I know he was a real doctor, I saw the diplomas.) He threw some pills at me and sent me on my way. Months later, still in pain and short of breath, I searched out a doctor (in another town) who ignored my dx, and stated that after extensive tests, the results showed that I had Stage IV cancer - mets to lung. That is what sloth and myopia will get you.
"(now the ears of my ears awake and
now the eyes of my eyes are opened)"
This is a very nice quote. I think it also captures well what is required to be a good scientist. As I understand it, Cummings is referring to a state of mind where one is attentive not only to the things that one already recognizes one needs to attend to, but to *every* aspect of a situation, even the seemingly unimportant.