Age of complexity

We could not agree more that medicine is an art of translation and that a complexity approach is important, as described by Martin et al in “What would an Ian McWhinney health care system look like?”¹

We have advocated for this for many years, suggesting complexity, the science for the 21st century according to Stephen Hawking, and chaos from which it arises, as a translation factor to the individual and to reality, and have proposed a complexity-based medicine to reflect this.^2–5

We also agree that McWhinney’s ideas for medicine reflect a complexity thinking, even though the vocabulary and concepts of complexity science were not available to him. It is intriguing to look at many other progressive ideas before the new age of complexity, to discover that they also reflect many elements of complexity thinking. An example is Rene Dubos’ 1966 essay, “Hippocrates in modern dress,”⁶ which reflects a holistic complexity approach. The art of medicine demands of the physician a holistic attitude very different from the typical scientific approach. It involves the ability to select, intuitively as it were, those aspects of the total medical situation in all its complexity, which can be manipulated not only by scientific medical technologies but also by any other kind of influence which promises to be useful. Seen in this light, the art of medicine appears so complex and personal as to be outside the scope of the scientific method, just as is artistic creation.⁶

It seems that, like McWhinney, Dubos had a complexity thinking for medicine way before complexity became known or popular. Now we have ideas from complexity science that can help us to understand our reality better, and to shape it for the future, as an art and science.⁵

We can now use readily available concepts and tools of complexity—the science for the 21st century—to address 21st-century issues that affect medicine and health, such as complexity-based medicine and a complexity-based approach to medicine and health.

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