{"id":991,"date":"2014-10-23T20:31:10","date_gmt":"2014-10-23T19:31:10","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=991"},"modified":"2014-10-10T09:22:53","modified_gmt":"2014-10-10T08:22:53","slug":"explosive","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2014\/10\/23\/explosive\/","title":{"rendered":"Explosive!"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/10\/Explosive.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-992\" src=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/10\/Explosive-150x150.png\" alt=\"Explosive\" width=\"150\" height=\"150\" srcset=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/10\/Explosive-150x150.png 150w, https:\/\/blogs.bmj.com\/adc\/files\/2014\/10\/Explosive-300x300.png 300w, https:\/\/blogs.bmj.com\/adc\/files\/2014\/10\/Explosive.png 512w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>Well, I thought that was a better title than &#8216;Volatility&#8217; which, to be fair, is closer to what this meandering post is all about.<\/p>\n<p>When we&#8217;re struggling our way through medicine, we have to face all sorts of uncertainties. Some of these are the <a title=\"Unknowns: known, unknown and uncertain\" href=\"https:\/\/blogs.bmj.com\/adc\/2010\/08\/16\/unknowns-known-unknown-and-uncertain\/\">frank face of ignorance (we just don&#8217;t know something)<\/a>, some of them are\u00a0about <a title=\"StatsMiniBlog: Bootstrapping\" href=\"https:\/\/blogs.bmj.com\/adc\/2013\/08\/08\/statsminiblog-bootstrapping\/\">the degree of chance<\/a> that plays into our knowledge, some <a title=\"A grain of sand.\" href=\"https:\/\/blogs.bmj.com\/adc\/2014\/09\/15\/a-grain-of-sand\/\">around the edges\u00a0where we decide which side of an imaginary line<\/a> things play, and on top of all these, we have situations where Stuff Changes. Not that we don&#8217;t currently know where things are going to end up &#8211; for example, that\u00a0we don&#8217;t have the diagnosis yet because we haven&#8217;t worked it out &#8211; but that it actually alters as we go through time.<\/p>\n<p><!--more--><\/p>\n<p>These are, for want of a better description, &#8216;volatile&#8217; situations. We may begin with a premature baby\u00a0who has periventricular flare, and we may end with a Member of Parliament with a string of illicit liaisons. The ultrasound wielding neonatologist cannot\u00a0be expected to predict a life course the progresses that way; there are too many things that happen, too many things which were not know because they were mere possibility, when the child&#8217;s scalp was splattered with conductive jelly. We may estimate some aspect of the life course (for example, the proportion of a population with flare who will have a degree of spasticity) but not others.<\/p>\n<p>If you believe in such situations, that also reflects a fundamental belief in your understanding of the world. You reject universal\u00a0determinism. Others may not, and believe\u00a0in a calculable &#8220;fate&#8221;.<\/p>\n<p>It might be worth\u00a0sometimes explaining, when you&#8217;re discussing uncertainties, that there\u00a0is a fundamental inability\u00a0in knowing sometimes. And sometimes, it&#8217;s that we don&#8217;t have the tools to tell, or enough data to be sure, and being clear about the foggy unsureness that you are discussing.<\/p>\n<p>&#8211; Archi<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Well, I thought that was a better title than &#8216;Volatility&#8217; which, to be fair, is closer to what this meandering post is all about. When we&#8217;re struggling our way through medicine, we have to face all sorts of uncertainties. Some of these are the frank face of ignorance (we just don&#8217;t know something), some of [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/adc\/2014\/10\/23\/explosive\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[79],"tags":[],"class_list":["post-991","post","type-post","status-publish","format-standard","hentry","category-archimedes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Explosive! - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2014\/10\/23\/explosive\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Explosive! - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"Well, I thought that was a better title than &#8216;Volatility&#8217; which, to be fair, is closer to what this meandering post is all about. When we&#8217;re struggling our way through medicine, we have to face all sorts of uncertainties. 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