{"id":974,"date":"2014-09-15T21:00:48","date_gmt":"2014-09-15T20:00:48","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc\/?p=974"},"modified":"2014-09-15T22:15:36","modified_gmt":"2014-09-15T21:15:36","slug":"a-grain-of-sand","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2014\/09\/15\/a-grain-of-sand\/","title":{"rendered":"A grain of sand."},"content":{"rendered":"

\"\"I am a glutton for podcasts, occasionally medical<\/a>, but often\u00a0way off this mark (sociology<\/a>, philosophy <\/a>& rugby league<\/a>\u00a0would fall into this category), yet they frequently play into each other<\/a>.\u00a0Some of you will recall this, as I note that when I can’t concentrate on a podcast, I know I’m becoming overloaded\/over worried and need to step away from stuff to regain my good mental health. Podcasts are my pants drawer<\/a>.<\/p>\n

However, my own state of mind is not the key in this entry, but an ancient philosophical problem.<\/p>\n

The Sorites Paradox.<\/p>\n

<\/p>\n

Here’s one grain of sand. Is it a heap\u00a0of sand?<\/p>\n

No?<\/p>\n

OK. Add another.\u00a0Is it a heap\u00a0of sand?<\/p>\n

No? … and repeat …<\/p>\n

At what point does it become a heap? How can 279 grains not be a heap, but 280 be a heap\u00a0of sand?<\/p>\n

Now take this to our world … why do we decide that a wheezy, snotty bundle of RSV-dripping joy can go home at 92% O2 sats, but must stay in at 90%? Is there any sense in this?<\/p>\n

(There’s a trial that’s looked at using a sats machine that lies<\/a> – tells you the sats are ~3% higher than they are – in this situation and showed no difference in outcome when the ‘low sats’ babies got sent home APART FROM the ‘true reading’ group got longer hospitalisations.)<\/p>\n

But even more interesting than that is the philosophy-in-life choices we make liminally – at the edges.\u00a0What are the thinking processes we use when we decide a platelet count is low enough to transfuse, or a cough prolonged enough to request a chest x-ray, or a referral to our child protection colleagues cannot wait for another visit with mucky T-shirt and too-tight shoes? We need to apply this same thinking to any categorisation in medicine; why was ‘that’ grouping used for the multivariate regression analysis<\/a>, for example?<\/p>\n

Have a good read of the Stanford blog entry <\/a>to work your way through it – its really worth it – and if you get hooked, try The History of Philosophy (without any gaps) <\/a>too.<\/p>\n

– Bob Phillips<\/p>\n

@drbobphillips<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

I am a glutton for podcasts, occasionally medical, but often\u00a0way off this mark (sociology, philosophy & rugby league\u00a0would fall into this category), yet they frequently play into each other.\u00a0Some of you will recall this, as I note that when I can’t concentrate on a podcast, I know I’m becoming overloaded\/over worried and need to step […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[79,2681],"tags":[],"class_list":["post-974","post","type-post","status-publish","format-standard","hentry","category-archimedes","category-practice-of-medicine"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/974","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=974"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/974\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=974"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=974"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=974"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}