Description
Ninety-Nine Lessons in Critical Thinking was designed to enhance the reader's awareness of how they think and how decisions involving patients and scientific matters can be influenced by word choice, preconceived ideas, framing, biases, and inattentiveness. Entertaining and informative stories from the author's 45 year clinical and scientific experience and from the history of medicine and science are presented to illustrate ways in which critical thinking skills can be developed and awareness of thought processes enhanced.The evolution of human learning and awareness is used to illustrate the fundamental nature of the concepts, and emphasis is placed on ways to enhance awareness of how our attention and words influence thought. Medical professionals (including medical students, residents, postgraduate fellows, graduate students, dentists, and nurse practitioners) are faced with an enormous amount of information coming from scientific literature, computerized patient records and artificial intelligence. Methods for dealing with this avalanche of data and ways to retain focus on key patient and scientific matters are explored, and practical suggestions to improve doctor-patient interactions are included, with a focus on approaching care regarding the patient's life context and personhood.The ninety-nine lessons demonstrate how to enhance understanding of the humanity of both the patient and the doctor and how awareness of thought is essential for innovative and compassionate care and research.
Table of Contents
SECTION I DOCTOR- PATIENT INTERACTIONS1. The World Is Too Complex To Perceive Directly2. The Key Factor Which Determines What We Perceive Is Our Attention and How It Is Focused3. Which Is Older, Stories or Books?4. Be Fierce, Nurture an Intense and Ferocious Aggressiveness in the Pursuit of Your Learning and the Benefit of Your Patients5. "Listen to Your Patient, He Is Telling You the Diagnosis"6. Be a Good Observer7. Consider the Patient's Experience8. Learn from Your Patients9. Intellectualization Limits Your Compassion10. Key Elements of the Patient Visit: The Interview and Deep Listening11. Words Influence Thought12. The Physical Exam13. Touch Is Important14. Be Prepared for the UnexpectedSECTION II DIAGNOSIS AND EVALUATION15. The Fundamental Three- Step Approach to Diagnosis16. A Mnemonic for Etiologies, VITAMINS ABCD17. Investigations18. Don't Be Afraid To Say You Don't Know19. Information Toxicity20. Treat the Patient, Not the Test21. It's Good To Be Knowledgeable, but It Is Necessary to Also Be Attentive to the Patient22. Consider Toxic Exposures23. Family History Is an Important Part of the Interview24. Rare Presentations of Common Events Are More Common Than Common Presentations of Rare Events25. Symptoms and Signs Have Important Significance: The Absence of Symptoms and Signs Is Not Always as Important as Their Presence26. Salutogenesis: The Production and Maintenance of HealthSECTION III MANAGEMENT27. Get to Know the Patient and Show Interest (the Patient Is a Person)28. Learn from Clinical Experience (but Not Too Much)29. Use the Placebo Response to Your Patient's Benefit30. Tell the Truth Whenever Possible31. Cognitive Function Is Relevant for All Areas of Medicine32. You Are Primarily Responsible for Caring for the Patient, Not the Family33. Denial of Illness and Disability Can Be Shared by the Patient, the Family, and the Doctor34. Consider the Context of Care35. Challenges to the Ability to Provide Humane Healthcare36. Do Not Confuse Etiology with Pathophysiology37. Communicate with the Patient38. Be Attentive to Medications and Medication ErrorsSECTION IV CRITICAL THINKING39. Think Deeply (Think Beyond the Obvious)40. How Often Do Rare Events Occur?41. Do Not Depend on Logic Alone42. Although Intuition Cannot Replace Evidence, It Can Be Valuable43. Should You Think Out of the Box?44. All Models Are Wrong45. Biomarkers Are Not the Disease Itself46. Absence of Evidence Is Not Evidence of Absence47. Being Wrong (at Times) Is OK48. Much of What We Know Is Wrong (So Don't Believe Everything You Read)49. Smart People Make Mistakes50. Fishing Expeditions May Be Productive51. Manifestations of Bias52. Experimenter Bias53. Bias of the Lost Actors54. Being Smart Is Not Enough55. Don't Be Afraid of Your Imagination56. Do Not Assume That Your Ideas Are Not Novel and Important Just Because They Appear To Be Obvious57. Consider the Evolutionary Aspects of DiseaseSECTION V PERSONAL AND CAREER DEVELOPMENT58. Live in "Day-Tight Compartments"59. Learn How To Learn and Enhance Your Learning Capacity60. Find Out Where You Find Meaning61. Search for Your Passion and Follow It (Gnaw Your Own Bone)62. Learn to Critically Read the Literature63. We Are All Neurologists64. Neurology and Cardiology (Etc.) Don't Exist65. Do Not Respect Boundaries, Be a Trespasser66. Be Grateful67. Look Beyond the Easiest Options and Pursue the Best Resources Possible68. Focus, but Not Too Much69. Be Persistent and Tenacious70. Do Not Be Intimidated by Accomplished Persons in Medicine and Science71. Accept the Help of Others72. Pay Attention to Your Own Health and Learn How To Deal with Stress73. Learn from the History of Medicine and Science74. Recognize Your Intellectual Ancestors75. You Are an Educator- That's One of Your Most Important Responsibilities76. Learn To Be a Salesperson77. Learn How To Learn from Bad Example78. Remember Pierre Curie, Carl Wernicke, and OthersSECTION VI DISCOVERY79. What Is Science?80. No Single Theory Ever Agrees with All the Facts81. There Is Only One Kind of Science, and That Is the Study of Everything with All Possible Methods82. It's Good To Be First, but It Is Not Necessary83. You Don't Need To Be Brilliant To Be a Researcher84. Appreciate a Diversity of Approaches85. Why Think When You Can Experiment?86. Judge Every Project by Asking "What Difference Will It Make To Know the Answer?"87. What Is Important in Research88. Do Not Be Obsessed with Technology and Methods89. Pay Attention to Study Design, Data Analysis, and Statistics90. Be Aware of (Beware of ) Statistics and Data Torturing91. Pay Attention to the Assumptions of Diagnostic Testing and Research Evaluations92. It Is Possible To Be Productive from a Distance93. You Can Make Contributions as a Clinician Without a LaboratorySECTION VII ETHICS94. Never Whisper in the Presence of Wrong95. You Are Responsible for Your Actions; You Cannot Let Others Take Responsibility for You96. The Need To Believe in the Guilty Victim97. Compassion Is Part of Our Fundamental Nature98. The Myth of Progress99. Don't Be Ageist
