Mary’s Room and Medical Education

The Mary’s Room thought experiment raises some ideas that are particularly useful when applied to medical practice and education.

I won’t review the whole thing here (watch the video for that), but here’s a summary of the possible situations Mary finds herself in (based on the thought experiment and the counterarguments):

  1. Mary knows everything academic about color but never experiences it (hence she learns something new in experience via “qualia”)
  2. Mary truly knew everything about color (hence the experience didn’t create any new knowledge)
  3. Mary never truly knew everything about color because not all knowledge can be conveyed via her studied literature and words (but maybe could be conveyed with more sophisticated means).

As they mention in the video, common consensus would probably be that there is a lot to learn from experience. Either because #1 is true or #3 is true. Indeed, ask any physician or other healthcare provider and I think they would agree. What if, instead, it was “Dr. Mary”… who knew all medical literature everywhere but she had never seen a patient or done a procedure? I wouldn’t want her as my doctor, and I think most people would also agree with this.

Even if the “right” answer to this thought experiment is that qualia doesn’t exist and all knowledge can be codified (option #2 above) I think most would agree that academically studying all that knowledge would be exceedingly difficult, if not impossible.

So, where does this leave us? No matter which possibility turns out to be true there is probably a lot of value to experiential knowledge.

All of this is to point out a major goal of MedCurbside. Modern medicine places a lot of emphasis on evidence and literature, and for good reasons. But sometimes we swing too far in this direction and forget that experiential/subjective knowledge is useful, but just needs to be handled responsibly.

Users have commonly told us they are inclined to dismiss online posts if they don’t see cited evidence. I think trainees are commonly taught that it’s inappropriate to learn from these types of sources because you don’t know what you’re getting. But at MedCurbside, we think there is a lot of valuable knowledge that lives in this nebulous zone. If doctors could learn everything they needed from evidence and literature we wouldn’t need residencies and fellowships. But we do need them, and we do need to pass on experiential knowledge in a responsible way and in a modern venue.

MedCurbside posts do place a heavy focus on literature (they earn more reputation points and evidence is auto-linked and imported in the sidebar), but it is not the be-all and end-all of knowledge. The posts can contain unique information that won’t exist in any publication. The community should read, share, and vote on these posts as well, so we all know which of them have validity and which don’t. They deserve the same scrutiny and attention that published literature does.