Correspondence |

The Chaos of War FREE TO VIEW

Robert G. Hooper, MD, FCCP
Author and Funding Information

Arizona Lung & Sleep Consultants, Scottsdale, AZ

Correspondence to: Robert G. Hooper, MD, FCCP, Arizona Lung & Sleep Consultants, 10290 N 92nd St, Suite 301, Scottsdale, AZ 85258; e-mail: csw4100@att.net

The author has reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Chest. 2008;134(5):1107-1108. doi:10.1378/chest.08-1513
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To the Editor:

Soldier recruits marching toward the enemy feel the uncertainty and fear of the upcoming conflict. However, bolstered by their youthful zeal and patriotism, fortified by their training and conditioning, and mesmerized by their faith and knowledge that others believe in the ultimate truth of their cause, they march into the chaos of war. Watching the recruits marching into the unknown, seasoned veterans of conflicts recognize the sincere optimism those recruits exude and the naiveté in their expectations.

A physician's wars are different. One soldier fights the emotional and biological enemies of one person at a time. Once our battle is engaged with the enemy, chaos often ensues. Like a real war, the planning, the terrain, the tactics, the objectives, and the definition of success change as the battle progresses. Knowledge of successful strategies and techniques is very important, but an ability to adapt to the evolving conflict is essential for success. For the physician, care is a continually changing process.

Evidence-based medicine, if it were ideal, would make sense of the chaos of our medical conflicts with disease, make our battle plans easier, make success more certain, and greatly lessen the daily stress of our (physicians') lives. Alas, it does not. The physician recruits with their strong beliefs are able to act without doubt. The veterans, battered by years of changing medical opinions and reversals of standard practices, reassess their decisions and problems each time they are encountered, and wonder whether each decision is correct as they decipher hundreds of facts using their years of experience, fitting the details into the case at hand.

As a medical war veteran of 30 years, I salute Dr. Tobin's eloquent essay1 on the current set of emperor's clothes that many in the medical community are worshiping.

Tobin MJ. Counterpoint: evidence-based medicine lacks a sound scientific base. Chest. 2008;133:1071-1074. [PubMed] [CrossRef]




Tobin MJ. Counterpoint: evidence-based medicine lacks a sound scientific base. Chest. 2008;133:1071-1074. [PubMed] [CrossRef]
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