I didn't know where to post this, so here goes. This is my attempt to think broad and deep as per Sandra Chapman's recommendations
I've watched and worked in the field of medicine since I started medical school in 1979 and graduated in 1984. My biochemistry professor worked with Krebs. It's been that long.
And I've observed how the field has evolved. Often what we thought was a good idea in the past turned out with more research to be not a very good idea at all. Some diversions into side paths became huge highways of progress, some tuned out to be dead ends.
I've seen enthusiasm trump caution (the Cox-2's are a good example, rushed through to market with inadequate testing. The new class of anticoagulants might very well be another one - if I needed decades of anticoagulation I'd choose warfarin over the novel agents, we have decades of experience with warfarin and only a few years with the newer ones). I've seen medications and approaches come, and go, and sometimes come back again (such as the aspirin flip-flop and flip again). I've seen what was once thought of as cutting edge disappear into obscurity.
I am not so arrogantly supportive of our current body of knowledge to think that now, in 2014, this is suddenly no longer the case and we now have certainty. I feel that in a few decades much of what we now understand about biochemistry and genomics will be considered rudimentary, just as we now look back from our not-so-lofty hillock on the last 5 or 50 or 500 years.
As this exploration proceeds, I feel we are still opening up tiny areas of the map. It is indeed less of an unknown continent that it was 5 or 50 or 500 years ago, but I feel that the vast majority of the landscape is still shrouded in darkness. I have had to work with this situation for three decades. Often I feel as if my work is smoke and mirrors, and I am but a companion in the health journey, sometimes as bewildered as the patient. Now I am in a situation where my own well-being is significantly threatened, and there are no broad highways to traverse. Instead, there are conflicting signs, there are snarling red-eyed beasts roaming dark forests of fear, there are quicksands of doubt and despair.
However, we do have to stand somewhere in this dark, uncertain, shifting landscape. I have hope that with time, more of the workings of our gene will become clear. And until then I have choices to make, so as not to be consumed by fear, doubt, despair or lost in depression.
So, for now, I choose a position of moderation, so as to give me flexibility to move as more information comes to light. I choose a position of standing back and trying to get a broad vantage of the whole landscape. I choose to walk in the fields of what we do know for certain. And I choose to celebrate what I have, every day - because today is still a good day.