I recently visited a physician (nothing serious, mind you, just one of those "I should probably go see a doctor sometime" sorts of feelings). I randomly chose a family physician; he seemed like a nice enough fellow, but honestly, I had no idea of his medical background or actual physician skills or anything like that. (Are physicians as dismissive of say, USMLE scores, as chemists tend to be of the chemistry GRE? How well do USMLE scores match, say, dead patients over a 25-year professional career?)
Anyway, all of that "how do you judge one medical doctor versus another" reminded me of a favorite passage
from a favorite novel (Neal Stephenson's Cryptonomicon
) about the main character, Randy, and his search to find a good oral surgeon to remove some particularly impacted wisdom teeth:
It was at one of these parties where Randy overheard a dentist extolling some brilliant young oral surgeon who had just moved to the area. Randy had to bite his tongue not to start asking all kinds of questions about just what "brilliant" meant in an oral-surgery context—questions that were motivated solely by curiosity but that the dentist would be likely to take the wrong way. Among coders it was pretty obvious who was brilliant and who wasn’t, but how could you tell a brilliant oral surgeon apart from a merely excellent one? It gets you into deep epistemological [s--t.]* Each set of wisdom teeth could only be extracted once. You couldn’t have a hundred oral surgeons extract the same set of wisdom teeth and then compare the results scientifically. And yet it was obvious from watching the look on this dentist’s face that this one particular oral surgeon, this new guy, was brilliant. So later Randy sidled up to this dentist and allowed as how he might have a challenge—he might personally embody a challenge—that would put this ineffable quality of oral-surgery brilliance to some good use, and could he have the guy’s name please.
A few days later he was talking to this oral surgeon, who was indeed young and conspicuously bright and had more in common with other brilliant people Randy had known—mostly hackers—than he did with other oral surgeons. He drove a pickup truck and kept fresh copies of TURING magazine in his waiting room. He had a beard, and a staff of nurses and other female acolytes who were all permanently aflutter over his brilliantness and followed him around steering him away from large obstacles and reminding him to eat lunch. This guy did not blanch when he saw Randy’s Mercato-roentgeno-gram on his light box. He actually lifted his chin up off his hand and stood a little straighter and spake not for several minutes. His head moved minutely every so often as he animadverted on a different corner of the coordinate plane, and admired the exquisitely grotesque situation of each tooth—its paleolithic heft and its long gnarled roots trailing off into parts of his head never charted by anatomists.
When he finally turned to face Randy, he had this priestlike aura about him, a kind of holy ecstasy, a feeling of cosmic symmetry revealed, as if Randy’s jaw, and his brilliant oral-surgery brain, had been carved out by the architect of the Universe fifteen billion years ago specifically so that they could run into each other, here and now, in front of this light box. He did not say anything like, "Randy let me just show you how close the roots of this one tooth are to the bundle of nerves that distinguishes you from a marmoset," or "My schedule is incredibly full and I was thinking of going into the real estate business anyway," or "Just a second while I call my lawyer." He didn’t even say anything like, "Wow, those suckers are really in deep." The young brilliant oral surgeon just said, "Okay," stood there awkwardly for a few moments, and then walked out of the room in a display of social ineptness that totally cemented Randy’s faith in him. One of his minions eventually had Randy sign a legal disclaimer stipulating that it was perfectly all right if the oral surgeon decided to feed Randy’s entire body into a log chipper, but this, for once, seemed like just a formality and not the opening round in an inevitable Bleak House-like litigational saga.
My doctor wasn't particularly awkward, but I guess I don't need a brilliant physician yet. Maybe someday I will (and who knows, maybe he is actually brilliant.)
(You have to love how Stephenson picks brilliant people - they read TURING magazine and drive pickup trucks. I guess I'll wait for the doc who reads OPRD
*bowdlerized for corporate firewalls.