“Those three little words”

This perspective in the current BMJ seems important to me. The author, Matt Morgan begins:

“If ‘I love you’ are the three most important words in life, then ‘I don’t know’ are the three most important in medicine. They’re also the most underused. Their power comes from admitting that doctors don’t, and can’t, know everything.”

Morgan goes on to say: “They’re difficult words to say. It’s hard to admit the limits of our knowledge, and sometimes it means hinting at the boundaries of medical understanding”

But Morgan concludes: “Yet these words also carry immense power: the power of hope, because there may be that chance to recover. They also carry the power to inspire people to strive for a better understanding of what’s not yet known.”


This BMJ perspective returned my thoughts to a prominent, but informal group of psychiatrists on social media who present themselves with great certainty about what constitutes evidence. My fear is that over-certainty can lead to “self-righteous” attitudes and behaviours – and that these can hinder our shared goal of greater understanding.

I recall once reading a novel by Julian Barnes, where this quote struck me:

 

 

2 Replies to ““Those three little words””

  1. I am seriously concerned that even these important three little words ‘I don’t know’ have been cruelly exploited by Pharma-Psychiatry to train GPs (in particular) to miss the clear symptoms of adverse effects of medications, and especially very commonly and widely prescribed ‘safe and effective’ (sic) antidepressants. I have written about this:
    https://holeousia.com/2019/04/12/the-right-stuff-or-the-wrong-stuff/
    I wish to draw attention to this very widely cited 2011 ‘Guidance for Health Professionals’ which is no longer accessible via RCPsych website. Doctors are clearly actively encouraged to ‘not know’ about the effects of the meds and to use ‘word scripts’.
    http://www.muns.scot.nhs.uk/wp-content/uploads/2013/05/MUS-RCGP-Guidance.pdf

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