I Don’t Know. But That’s Alright.

Not too long ago, I diagnosed a patient with sarcoidosis. She asked me what was the cause of her disease and I offered her that I have two versions of the answer: a short one and a long one. She requested for the short one, which I said “I don’t know”. I went ahead and gave the long answer too, as I can read in her face that she was not satisfied with my short version.

I told her that sarcoidosis results from a specific type of inflammation involving lymphocyte and mononuclear cells forming caseating granuloma, which in some theories said could be triggered by occupational or environmental exposures, while other theories implicate infectious agents, some think it is an auto-immune disease, and some believe it has genetic association — but all theories are not proven, so we really don’t know. I think I made her more confused after that, but she was satisfied with my answer.

There are so many things in this world that we still don’t understand and we don’t have answers to. Of course there are more things that have answers, but you and I, as an individual, may have not just learned it yet. And I think there’s nothing wrong to admit if we don’t know them.

I have been asked by patients questions that I don’t know the answer, and I tell them so, but promised to looked them up and study to provide an explanation for them. I also have been asked by my medical residents and students during hospital rounds, questions that I don’t know the answer and I admit to it. So I tell them I’ll read up on it, or better still, I tell them to research on it, and give us an informal report the next day, so they could learn it better (we tend to retain information better when we read it ourselves rather than hearing it from somebody else) and so I could learn from them too (students can teach their teachers more ways than one, you know).

I remember our Principal during my high school days saying: when we finish high school, we think we know everything; when we graduate from college, we find out that we know something but not everything; after graduate school, we realize we really know very little, but so does everybody else. I find that statement very true, for the more knowledge we gain, the more we discern how little we really know.

I don’t think we show our weakness when we admit that we don’t know. But we show our strength when we do something about what we don’t know. We show our true ignorance when we don’t admit that we don’t know, and worse if we don’t do anything about it, or even pretend that we know.

So what is that theory of relativity again? I don’t know. But I’ll look it up (though it does not guarantee I’ll understand it!).