DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Epistemocrat – a Black Swan term

I am currently reading Black Swan. Over the next few days, I will likely share some observations which the book has suggested. This morning I finally understand the term epistemocrat. I was aware of the term because of a blog that I occasionally read, and which links to me – healthcare epistemocrat

In the book, the author poses the challenge of reconstructing history from the clues of the present. Medicine represents the ultimate such situation. We are faced with several clues – symptoms, signs and the patient’s recollection of the events leading to the current situation. Our job is to construct a feasible story which explains the events, and if possible search for clues to support or reject our story (lab tests, imaging studies, tincture of time with observation.)

Please read the quote carefully – it will help you start to understand the subtle importance of this concept.

What is an epistemocrat?

In his marvelous book, The Black Swan, Nassim Taleb defines an epistemocrat as “someone of epistemic humility, who holds his own knowledge in greatest suspicion.” For Dr. Jerome Groopman, this person continues to search for answers by asking, “What else could it be?” From Dr. Chester Newland’s perspective, an epistemocrat never stops “searching for human dignity.”

Epoche, a Greek word that translates as “suspending judgment,” lies at the heart of an epistemocrat’s quest – a quest that began many years ago in medicine by empirical skeptics like Sextus Empiricus and Aenesidemus (founder of Pyrrhonism).

Today, an epistemocrat is an “anti-scholar,” a person who, concerned with what he or she does not know, engages in life-long learning and erudition to hedge dynamically against uncertainty.

Essentially, an epistemocrat is a practitioner (a thinker and a doer) who embraces (via paradoxes) the humble limits of being human and searches (via stochastic tinkering) for practical, real-world solutions that help us live and grow together in our increasingly complex and recursive world: opportunistic generalists tend to survive …

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