Thursday 25 June 2009

All items reduced... part 2



(Part 1 is here)

Well it wasn't a leaf!

The problem is that you were only looking at part of the picture.

Here in this simple analogy we come to realise the great danger of reductionism, and how errors can creep into our thinking. The closer we get to a topic, the more we zoom in, the narrower our field of view becomes, until we eventually lose sight of the whole picture. Where the picture is relatively simple this isn’t a problem. The reduction can tell us just about everything we need to know. Reducing the flight of a passing comet to be an object that follows clear, definable laws of physics allows us to predict with incredible accuracy the next time when we’ll see that comet again. All well and good. But what about something more complicated?

Disease

Some diseases lend them self to a reductionist approach. A single point mutation in a length of genetic code can wreak havoc. Whilst the symptoms may be complicated, reduce it down to the level of the gene and we find the cause of the problem. Yet most of medicine isn’t quite so simple. Many diseases have much more complicated causes, they can affect different people in different ways, and treatments that work on one individual might not work on another. Then there are the psychological issues. What effect do they have? The reductionist is doomed to failure. That’s not to say that there isn’t a logic to what is happening, there is, but it cannot be reduced. Doctors have long realised that to be successful they have to take a holistic approach, tailoring their treatments to the patient and looking at the whole picture.

Reductionism is a great tool for solving 1-dimensional problems. It has its uses in more complicated situations as well but these are limited because often a 3, 4 or 5 dimensional problem cannot be broken down into components. Each aspect affects the others; unless you have them altogether the picture isn’t true. Perhaps we see this most clearly when we start to look in the mirror.

1 comment:

  1. "Doctors have long realised"

    I would argue that some doctors have long realised but many still cling desperately to the 'one size fits all,' 'one treatment for one condition', 'treat the symptom not the cause' model which frustrates a lot of my patients!

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