Just before I retired as a UK general medical practitioner, I amazed myself by calculating that I’d had something like ¼ million face to face consultations in my career. That’s a lot of experience, and a lot of talking, but conceals something about the nature of medicine as an academic discipline. British general practice acts as gatekeeper to specialist care, so those consultations had to deal competently with anything that came through the door, from the common cold to cancer, or from work stress to schizophrenia. Medicine is a science, but if it’s hard for a cardiac surgeon to keep abreast of the literature, it’s actually impossible for the working GP, even if he restricts himself to the stuff he will manage personally, without considering the specialties to which he must refer patients intelligently.
The review article, therefore, is his main bastion against cumulative ignorance. Yet even a brief foray into the research shows how often reviews misrepresent the primary literature, and how the latter, too, frequently draws wrong conclusions from the raw evidence. It is not rare to find (usually after several years) that even national professional guidelines have been based on such misinterpretation.
Where lies authoritative guidance in such a situation? For the working doctor, management in practice ends up being based on a complex mixture of personal education, peer norms and bloody-minded recourse to clinical experience.
This is not merely a dilution of truth, however. The sole area in which I could say I was better informed than most of my GP colleagues was in the field of back pain. By the rather ad hoc process that constitutes in-post GP training here, I had become increasingly interested in this over 25 years and was eventually asked to set up an area clinic, with the support of several of the specialists who deal with this Cinderella condition: rheumatologists, neurosurgeons, orthopaedic surgeons and pain consultants. It quickly became clear how their undoubted academic excellence stopped at the boundary of their field, so that they had a strong tendency to belittle, or ignore, the different approaches offered by the others. The fact that I interacted productively with all of them arguably gave me a better overall insight into back pain than any particular one of them, though they were each better-qualified and far better-read in the research literature. My point is that, in some circumstances, the correspondence between academic qualification and practical authority can be far from clear-cut.
In all this any medic has to remind him or her self that the real academic goal is not so much to arrive at the truth, but to apply that truth therapeutically and educationally to the patient, a complete lay-person. One’s medical credentials are only as good as one’s ability to bring truthful understanding to ordinary people – no more, no less.
Bridges or battlements?
I have described my professional experience as a rather extended analogy to the BioLogos project. By its very nature, BioLogos is interdisciplinary, intended to bring together at least two fields, science and religious faith, often considered to be entirely incompatible. In academic terms this separation is clearly true. Pain specialists and orthopaedic surgeons may often not read the same journals, but molecular biologists and Old Testament theologians can be almost guaranteed never to meet in the library. Yet the only useful purpose for their involvement in BioLogos is to help build bridges between their disciplines. Correction – they actually have a higher purpose, which is to enable ordinary believers to cross the bridges so built in safety.
It can be very tempting for trained professionals to succumb to academic one-upmanship. Even John Wesley, champion of lay-preaching, was not above sniffing at his opponents for their lack of grounding in the Biblical languages. The flexing of academic muscle can occur at the broadest level: “How can you, a theologian, possibly have a worthwhile opinion about biology?” (or vice versa). But more local rivalries may also rear their heads: “He’s a theoretical evolutionist – when did he last get his hands dirty in the lab?” You’ll be familiar with other examples with a little thought.
All such attitudes ignore the self-evident truth that in an interdisciplinary pursuit, everybody is a layman. That’s why it’s interdisciplinary. What is a geneticist, or a school-teacher frequenting the website, to do? Accept the theological conclusions of Biblical scholars simply on authority? And if the theologians or scientists disagree amongst themselves (which, believe it or not, occasionally happens), do they tot up the PhDs and submit to whoever has most? And equally, must the theologian or pastor exercise passive obedience to the divine right of palaeontologists to rule on the fossil record?
The bridges are going to be built only by people willing to venture into the other person’s field, and by those willing to welcome them and further their endeavours, rather than defending their own patch from interlopers. Neither does the BioLogos project require mutual respect only between theologians and biologists. How can one understand Genesis without input from ancient historians, assyriologists, mythologists and archaeologists? How can one explore the interface of faith and science apart from church and science historians, sociologists and philosophers? How can one assess the spiritual importance of these issues without the input of pastors?
Each brings special expertise and training to bear on the questions, but each also inevitably brings both personal and professional bias. It’s a fact of life that experts sometimes get things badly wrong. A layman will take an academic’s assertion of another professional’s incompetence with a pinch of salt, especially when they come from rival disciplines. Given how common such personal attacks seem to be in academia he will soon be suffering from salt overload. It’s also a fact of life that those outside a discipline will be entirely unimpressed with its presuppositions. If a majority of OT scholars believed that Genesis was written by King Nebuchadnezzar, a computer engineer would have no reason to accept it on their authority, when he lacks opportunity or training to study the academic literature. It has to be proven to him, frustrating as that may be for the scholar.
Drawing strip cartoons
A (probably apocryphal) quote by a celebrated scientist says that if a theory is too complicated to be explained in strip-cartoon form, it probably isn’t true. I’d hate to be the cartoonist responsible for quantum mechanics, but the idea does have relevance to a broad enterprise like BioLogos. The only real value of academic credentials to an assembly of individuals from such different intellectual fields, or from none, is to have the ability to express informed truth in a way that is understood by, and persuasive to, those outside one’s own discipline.
In the end if only specialists are qualified to decide the truth of propositions, those propositions aren’t particularly worth believing. Yet specialists are uniquely equipped to bring sufficient understanding of those propositions for ordinary people to make up their minds with some degree of confidence, and to learn in the process. This, however, has nothing to do with ones tenure of a University post or publication history, and everything to do with the human values and communication skills one picked up along the way.
Or so my patients used to tell me.