The dilemma's horns: basic science and the clinician.

Abstract

The dilemma, so called from the resemblance of its presenting bony parts to an archaic and discarded Greek letter, is a widely distributed, undomesticated, and sometimes ferocious creature. One reads and hears frequently of persons who have been caught on the horns of one. The species I would discuss is the common dilemma of medicine. It has a ferocity all its own. On one of its horns rests, uneasily, basic science and on the other, confidently, clinical medicine; the dilemma relates the two. THE PROBLEM I suppose most younger clinicians are only vaguely aware that bedside medicine and basic science have for years wondered what each had to do with the other. Most of the older ones think basic science at least a doubtful part of medicine and act as though it were a menace, with no other purpose than to obfuscate the practical management of patients. Basic scientists in