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A Short Theory About Medical Lore

lore /lôr/


  1. a body of traditions and knowledge on a subject or held by a particular group, typically passed from person to person by word of mouth.

Over Coffee...

Kristin and I were having coffee this morning, and the topic of lore in medicine came up. We were discussing one possible way in which some lore might be created. This is purely an opinion blog, but I thought it would be interesting to share the gist of the conversation in this short post.

Do you think there's any truth to this theory?

The Secret Skeptic

Imagine a classroom where students are listening to their instructor explain a topic. One of the students in the classroom thinks of an alternative theory to explain what the instructor is teaching. However, they don't express it - they keep it to themselves. The student pretends to accept the instructor's explanation so they can pass the test. However, in the student's mind, the instructor is wrong, and they're right. The student's theory seemed to make perfect sense to them, while the instructor's explanation just never seemed to click.

Some time passes, and the student has now graduated and is working as a paramedic. The student has now become the teacher - a student ride-along joins them in the ambulance. Finally, they think - the perfect chance to right the wrong taught in school. They explain their convincing yet inaccurate theory to the ride-along.

The lore has begun.

The cycle continues.

We Need Skeptics

Students especially, but clinicians as well, are always afraid of looking stupid in front of their peers. No one wants to be the student who doesn't understand a complicated point and asks what people may perceive as a 'stupid question' in front of everyone. When everyone shakes their head in agreement, it isn't easy to go against the grain and say, "I don't get it!"

This could create resentment in the student against the answer they didn't understand, which might, in turn, motivate them to prove their point to others who don't have the knowledge base to argue effectively - justifying their opinion by promoting it as fact.

This isn't to say that the student is wrong. The 'lore' might actually be correct. Perhaps the instructor was actually dead wrong. The point is that there is no intellectual discussion occurring in a place where the truth can be expressed for the benefit of everyone listening.

We need skeptics in medicine - people who don't take an authorities word at face value. Skeptics challenge everyone's beliefs and force them to think about why they believe what they do. We should encourage students to disagree, argue, and debate their views with evidence. They just might be right. However, we'll never know unless they feel they are safe to disagree.


The conversation we were having this morning really reminded me of the importance of open discussion and the freedom to challenge ideas. There is an art to rhetoric and debate. Perhaps it would be beneficial for instructors to challenge their students to come up with alternative theories, true or false, and debate those ideas. Maybe some of you are already doing this. I picture a classroom where multiple groups are created. One group is given the real answer, and the other groups must devise alternative theories in a game to figure out who was given the honest answer through debate.

Thanks for reading our coffee thoughts!


1. Starbucks coffee


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