Science vs. Gut Feeling - Can They Coexist?

I have accumulated countless memories as a doctor. One of the most pointed, however, occurred years ago, early in my career.

It was right around Thanksgiving and I was caring for a first-time pregnant mom. She was past her due date, which is not unusual for the first baby. Protocol called for a non-stress test (15 minutes of monitoring heart rate trends) twice weekly until delivery to ensure that the baby was thriving in the womb. My patient had her first test just after her due date and everything was fine. Because of the holiday, she would otherwise have her next test four days later. Early in the interim, though, I got an uneasy feeling that I could not shake that something may be wrong. 

I got a second test two days later - earlier than protocol. On that day I happened to be running some holiday errands near the hospital. My cell phone rang as I drove past the hospital and it was an obstetrical colleague of mine. The baby was in serious distress and they were heading to c-section. Within 10 minutes I was in my scrubs and inside the operating room.

It was a boy!

On that day and a few other times during his several week stay in the hospital’s neonatal unit, he came within an inch of death. But today he thrives. Every time I see his piercing blue eyes and consistent smile flanked by dimples, I am reminded that life is a precious and sometimes fragile gift. I am also reminded to always trust my gut feelings.

I am a scientist and I trust my gut feelings.

These two stances may seem contradictory in an era where evidence-based medical practice reigns. My electronic medical record prompts me to follow particular guidelines. Insurance companies look over my shoulder making sure that these guidelines are followed. Still, putting my hands on patients each day, I get a sense that each person is a complex and unique creation. I also believe in notions like "everything happens for a reason" and that we have a soul.

Let’s face it - most things we can explain. 

They fit into a box that can be organized by scientific method. Trends, averages and consistent findings yield guidelines. Guidelines bring expectations and doctors are asked by science (and health insurance companies) to put their patients into these neat and tidy little rows.  Unfortunately, we are not all round pegs that fit perfectly into round holes.

While I read trends and guidelines, I also read my patients. They have body language and mannerisms. They worry and respond to their own gut feelings.

Medicine is the art of heeding these signs in a marriage along side science.

God speaking, a gut feeling, a hunch or tingling spider senses - whatever you call it, I’ve experienced and heard tell of this phenomenon too often to ignore it. And, as a scientist, I recognize the merits of the scientific method. I believe, as I do in several other aspects of life, that a balance exists, utilizing the best from both areas. Like a coin, there are two sides. I would encourage you, as a caring and rational human being, to embrace both sides as you grapple with reason.