Consilience: it's a word that rolls smoothly off the tongue and that dates back to the 19th century. It was coined in 1840 by the English philosopher William Whewell (who also gave the world the word "scientist"). He used it to describe commonalities in cause and effect across different disciplines. The word was derived from the Latin consilire, a compound of con- (together) and salire (to leap). It means, to paraphrase the definition in the unabridged Webster's Third New International Dictionary, accord between the governing principles of one realm of thought and those of another the concept that the laws of physics and the laws of biology, for example, are more similar than they are dissimilar.
Yet the word was so little used until very recently that it doesn't even appear in the latest edition of Merriam Webster's Collegiate Dictionary, the condensed version of Webster's Third. It may roll off the tongue, but it didn't roll off many tongues.
Then, in 1998, naturalist E.O. Wilson, a Pulitzer Prize-winning author, used the word as the title of a book that garnered much critical and popular acclaim. Consilience: The Unity of Knowledge made the bestseller lists and was called "truly a magnum opus" (Booklist) and "an arresting exposition" (New York Times). Wilson's thesis is that all the sciences, as well as the humanities, the arts, and even religion, need to be studied and understood togetherthat "the world is orderly and can be explained by a small number of natural laws." It was a bold proposition in this day of increasing subspecialization. Suddenly, the word "consilience" was hot.
But what does it have to do with this issue of Dartmouth Medicine? Well, we seem to have unwittingly embodied consilience. We make a concerted attempt in putting the magazine together to choose articles on a range of topics, in the hope of catching each reader's fancy with at least one or two pieces in a given issue. Yet despite our best effort to achieve variation, when all the contents for this issue came together as a unified whole rather than as separate bits and pieces, I was struck by some themes that recurred again and again.
For example, the importance of humanism in medicine is part of the story on page 7; the essays on pages 19, 21, and 64; and the feature on page 22.
The argument that health is a global issuethat the developed world neither can nor should be complacent about what is happening elsewhere, from the microbial level to the societal levelis central to the piece on page 7; the essay on page 21; and the features on pages 22, 36, and 44.
The point that complexitywhether scientific or societal or ethicalis an ever-present challenge in the modern world but is susceptible to considered thought is made in spades in the features on pages 36 and 44, as well as in several other stories.
This point would also have been made in two stories that didn't end up in the issue, largely because of timing (there is complexity in putting together a magazine, too!). One concerned a new module on legal issues in a fourth-year course called Health, Society, and the Physician. After hearing about such topics as negligence and informed consent, the students divided into small groups that each researched a case study. The topics of the case studies included the reporting of child abuse; the allocation of liability between a resident and an attending physician; the assignment of negligence in a managed-care setting; and the documentation of sensitive information. The groups "did an extraordinary job" exploring these thorny issues, according to a faculty member involved with the course. The second story-that-might-have-been was about stem cell research. Dartmouth's Ethics Institute held a day-long symposium with noted speakers addressing both sides of this much-debated issuewhether and how such research should continue and by whom it should be funded. At the end of the day, attendees got a chance to "vote" on the issue. Their responses were thoughtful and nuanced.
And then there's the heartening theme that despite all the challenges and complexities facing the world, the determination and commitment of one individual can make a difference: This point is suggested in the feature on page 28 and is made in various ways in the stories on pages 3, 6, 7, 11, 21, 60, and 62.
Our hope in sharing all these stories with you, our readers, is that we can make a small difference in your understanding about . . . well, about the consilience of these fascinating issues and about Dartmouth's role in elucidating them.
Dana Cook Grossman
Dana Cook Grossman
Laura Stephenson Carter
Roger P. Smith, Ph.D.
Jon Gilbert Fox
Robert Gosselin, M.D., Ph.D.
Joan Crane Barthold, M.D., '85
James L. Bernat, M.D.
Judith E. Frank, M.D.
Mahlon B. Hoagland, M.D.
Mirna Jusufbegovic '01
Katherine J. Little, M.D.
Fred Louis III, DC '58
Thomas L. McFarland
Joseph E. Melton, Ph.D., '82
Maureen S. Micek, M.D., '90
H. Worth Parker, M.D., HS '75-83
Heinz Valtin, M.D.
Jennifer Vines '02
Charles R. Wira, Ph.D., '70
Derrik F. Woodbury, M.D., '77
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