SCIENCE

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So much of this site arose from the work of this program, I thought it would be useful to review how it started, the progress over the years. A few will want to know.

I do not intend a year by year recounting. It is only these first few years that get their own articles. They set the structure of everything that came afterwords. Not the science, nor the clinical work, but the way in which clinical work and science integrated and – most especially – the kinds of science we did. For, as I am pointing our, the initial structure was strongly biased toward empirical research, from the beginning.

I did not know that, as I did not really understand science per se. Only now has it become obvious.

Also unique, the first few years I worked alone, so the personal pronoun was the right one. After a while, people came and science arose from them, usually as much or more than from myself.

MY SCIENCE 1968 AND BEFORE

I was finishing my training in Nephrology, and decided to build a patient care /research program centering on the use of computers – then the rising star of new science. It became the Kidney Stone Program.

MY SCIENCE 1969

I began my employment at Michael Reese Hospital and as Assistant Professor at University of Chicago in January, and built the protocols and laboratory for the kidney stone program. We enrolled the first patient in October of that year.

 

Empirical science is ancient beyond imagining, for it is nothing more than the modern version of exploring to find out what is there. Don’t you do it after checking in to the hotel in a city new to you? Go out on the streets and see what is going on, where things are? How people dress, what there is to do? This video, the second in the series, tells about this most reliable and fundamental branch of research science.  The first video in this series, the one that preceded this one, tells about all three branches of science, and is useful here as background.  The featured image that depicts the death of Captain James Cook, painted by Johan Joseph Zoffany … Continued

This entire site concerns the science from which we have derived what we offer to patients for prevention of kidney stones. Every article rests on a base of established and peer reviewed science. This video tells about how science works. We Have Always Had a Science Page For years I have posted articles about science, for those interested. But they have been a mixture of things that interested me from time to time, not an organized primer one could learn about science from. I have made such a primer and plan to present here, on this site. Partly I needed to capture the ideas of science in a physical form to teach it with. Partly I needed to capture ideas … Continued

In 1968, I was near the end of my training in renal medicine, at University of Texas SW Medical school,Dallas, and it was time to plan my next few years. I had a job, back at the school I graduated from – University of Chicago – stationed at Michael Reese Hospital. I had some money to build a program and no idea of what to do. The picture is from 1968 and shows the Chair of Medicine meeting with house staff. I was not in this picture. William Yeats and Unity of Being My last teacher, Donald Seldin, Chair of Medicine at UT SW got me reading Yeats. Among his ideas this one seems somehow very important to me. Life has … Continued

Pieter Brueghel the Elder [Public domain], via Wikimedia Commons

Why Science Matters DRAFT – NOT COMPLETE AT THIS POINT What Am I Writing About? About medicine, all we know of any practical consequence more than what was said in Babylon comes from science as practiced in the West since Harvey and Galileo. And, of all topics in medicine, my rather global and presently unsupported assertion applies remarkably to our common project here, the prevention of kidney stones. To say this more exactly, rational, modern, effective kidney stone prevention arises naturally from knowing what crystals make kidney stones and what forces drive such crystals to form. Prevention arises from cause, cause from science. Why Am I Writing This? Few would doubt that science drives medical progress, so why have I … Continued

I have no illusions this will have mass appeal, but the topic is important and many patients may have an interest in how medicine and science work together in general and in this disease as a particular example. Unlike the rest of this site where I am redacting and elaborating well known themes, here I am forced into originality by the general poverty of writing on the subject. For those who like this kind of writing, the Site Logic Page is its natural home. For those who do not – no doubt a vast majority – pass by.

I have alluded to objectives in my discussion of applied, basic, and empirical science, which was a good place for their first mention but too narrow for a proper exposition. They are in the first case an expression of need, in the second case of desire, and in the third arise from perhaps an altogether different source. Here I am concerned with objectives of applied medical science. CLASSES OF NEEDS What can be the perceived needs of medicine but treatments, prevention, tests – to aid diagnosis or prognosis, methods, techniques and devices? EXAMPLES OF EACH CLASS Consider a patient with calcium oxalate stones not due to systemic disease, ‘idiopathic’ stones. Treatments This refers to stones present; they are there and surgeons need … Continued

WHAT IS THE QUESTION? I understand that some physicians are skilled basic scientists, and that many physicians enjoy reading about basic science. But how does a knowledge of basic science benefit the patients of physicians who have such knowledge? There are two parts to this question. How can being a basic scientist benefit a physician in the practice of medicine, and how can a knowledge of the results of basic science benefit a physician in the practice of medicine. Of these two, I mean to consider only the second: How does a knowledge of basic science results benefit the practice of medicine. Of course, here, I mean practice of medicine concerned with kidney stones – the disease within the province of this site … Continued

Three Sciences of Medicine Certainly we all agree that modern medicine takes its power from science. One kind of science concerns how we can do things. Let me call it ‘applied science’ for want of a name. The other kind concerns how nature does things. This is often called ‘basic science’ or ‘natural science’. Drug development and drug trials are obvious examples of the first. Mechanisms of disease are examples of the second. These statements are so obvious I hesitate to make them, yet in such phrases as ‘evidence based medicine’, ‘basic vs. applied science’, ‘personalized medicine’, and ‘translational research’ the distinction, itself perfectly clear, can blur. If basic science seeks to learn how nature does things, empirical science seeks to … Continued