A Clinician’s Quest for Certainty

Abstract

John Gedye began his paper by quoting Simone de Beauvoir who laments the fact that words force her into rigid categories, into blacks and whites that ill match a world in shades of grey. Inexorable, then, she cries, that in such a world truth should dwindle into insignificance. This is a cryptic saying to introduce a paper which will seek to strip the clinician of his customary grey language and force him to “black and white” assertions (p. 109) and “stringent criteria of certainty” (pp. 105–106). “Only when we have no alternative…”, Gedye admonishes his fellow-clinicians “should we accept having to fall back into the ‘gray’ world of weak probabilistic arguments” (p. 109). Are we to infer, then, that in the world of the clinician truth is doomed to dwindle into insignificance? I cannot believe that this is what Gedye intended, yet this is the moral of de Beauvoir’s remark.