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March 18, 1998

Modern Medicine and Chaos Theory—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(11):835-836. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-11-jac80001

In Reply.—Dr Theodoropoulos and Dr Manian apparently both subscribe to what might be termed the patient-centered sentiments in my article, but are less comfortable with the utility of the chaos metaphor.

I suppose that I could have made clearer that chaos was used as a metaphor to provide a different way of looking at the problems of modern medicine. Modern medicine does have many problems. I have found that if I do not wrap any discussion of these problems around stories or metaphors, my tone becomes too shrill, too negative, too whining.1-4 Although I love the practice of medicine and I love scientific investigation, I worry very much when one masquerades as the other.