The New Level of Thinking in Medicine

Water: For Health, for Healing, for Life: You're Not Sick, You're Thirsty!
by F. Batmanghelidj, M.D.

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What is a paradigm, and how can it be changed in clinical medicine? A paradigm is the basic infrastructural information, assumption, or understanding on which knowledge within a discipline of thought develops. As an example, based on the fundamental understanding that planet Earth is a sphere, all geographic maps and models reflect the roundness of Earth. This understanding is the basic paradigm to the design of all geographic maps. The dramatic changes produced by the realization that Earth is not flat, as originally perceived, revolutionized the knowledge we now possess about the structure of the universe. When a paradigm leads a discipline of thought toward a dead end (as in the case of a flat Earth), for those who can stand back and impartially reassess the infrastructure of knowledge, often a new paradigm emerges. All it takes is a thought-triggering association or observation.

When a valid paradigm that is basic to a major discipline of thought emerges, it illuminates the path to a vast new domain of knowledge, like a flash of lightning that reveals all in the darkness of night. A new paradigm removes restrictions and barriers and makes future progress within a discipline of thought possible.

A new paradigm is more easily born when there is a specific need and a purpose to find a solution. A solution does not establish significance unless a definite need to the emerging solution is also recognized. The following story may help explain this thought.

Sir Alexander Fleming was the Nobel laureate recognized to have discovered penicillin. He was a Scottish scientist who worked at the Wright-Fleming Institute of St. Mary's Hospital Medical School of London University when I was a medical student there in the 1950s. Many medical students have an emotional urge to become discoverers. I was no exception. Since childhood, I had been driven to study medicine and become someone who could positively affect the lives of people who fell sick.

In the introductory bacteriology course, students were divided into small groups and assigned to different tutors. Luck placed me in the tutorial group assigned to Sir Alexander. He was a refined and humble man. At the end of the tutorial, I gathered enough courage to ask him a question, the answer to which has deeply influenced me ever since.

I asked him, “Sir Alexander, is there a special way to become a discoverer in medicine?” He looked at me and pondered my naive question. After a pause, in a very refined Scottish brogue he replied, “Need and purpose.” He explained that with the increasing introduction of different surgical treatment procedures into medical practice, there was an ever-increasing rate of fatal bacterial complications. To find an agent that would stop bacterial infections in the human body became a most urgent need that established a purpose and resolve for those in bacterial research. “Need” was the mother of penicillin's discovery, and “purpose” the impetus of its development for human application.

About the Author

Dr. F. Batmanghelidj, was born in Tehran, Iran, and now lives in Falls Church, Virginia.