The Joy of Discovery

Kids love to experiment. That’s why they will often try to stick their fingers into sockets – they want to see what will happen! We humans are naturally curious. While our curiosity is sometimes suppressed by an education system that places too much emphasis on learning what is supposedly already known (often called ‘facts’), we do, occasionally, get opportunities to explore the world for ourselves. Thus, it was, in my final year of secondary (high) school, while doing a biology project that I discovered how fast (or, more accurately, how slowly) sea snails move on a rocky beach. I don’t have the answer right now, but it was fun trying to find out. I spent many happy hours painting (with nail varnish) the shells of snails I found within one metre grids - returning next day to see how far they had moved. Answer – mostly not very far although some seemed to have moved too far – probably swept out to sea on the tide!

I have since gone on to investigate some rather more important questions. Thus, while undertaking an intercalated year in physiology during my medicine course, I became involved in a study of whether mitosis in rat oesophagus exhibits diurnal variation. Answer – yes, it does. Now you might well ask how is that any more important than the speed (or lack thereof) of sea snails on a beach. Its importance derives from the fact that rat oesophagus happens to be (or, at least, was at the time) an important model used to study change (including malignant change) in the oesophagus of the rat – and by association of the human!

Research is integral to the growth of medical knowledge and the evolution of medical practice. There is a wealth of opportunities to participate in research and contribute to this endeavour available to any medical graduate. This includes general practitioners, notwithstanding the impression among some hospital-based colleagues that general practice is a quiet backwater where the quest for new knowledge does not prevail. Nothing could be further from the truth. Research in and on general practice is as old as the discipline itself. There are several giants of general practice research. One such is Will Pickles of Wensleydale who, through meticulous epidemiological work in his general practice, determined the incubation periods of several infectious diseases. Another is Franz Huygen who, through by tracking patterns of consultations by different family members, showed how illness in one person impacts on their family members in ways that had not previously been recognised. Happily, there are now departments of general practice in all Irish medical schools with GP researchers beavering away investigating problems and challenges that beset our practices, ourselves and our patients.

When, as an aspiring academic, I first became involved in general practice research, I set out to understand why I sometimes felt uncomfortable after writing a prescription for a patient. I quickly learnt that I was not alone but that, indeed, this was a common experience among GPs. Through further exploration of the issue, I learnt that there were many factors influencing whether or not issuing a particular prescription felt uncomfortable. This was not, as I had initially supposed, necessarily a problem. Discomfort experienced while writing a prescription is related to a range of conflicting considerations - both medical and sociological. Indeed, on completion of my study, I realised that if you never felt uncomfortable about some of your prescriptions it is likely that you are making mistakes or prescribing inappropriately without even being aware that you are. Discomfort is an indication that sometimes, when prescribing, there are complex issues being finely balanced by a prescriber striving to do the maximum good and the least harm. This has led on to a career during which I have undertaken several more studies exploring different aspects of the prescribing decisions of GPs.

I will not pretend, though, that research is always exciting and fun. It can be hard work and even, at times, boring and tedious. There is usually element of slog involved in collecting your raw data and a considerable risk of something not working out as planned or going wrong at some stage. Nonetheless, if you get involved in research you will have the satisfaction of knowing that you are making a unique contribution, however small, to the fund of human knowledge. And knowledge is mostly accumulated by a process of slow accretion – somewhat in the manner of how stalagmites form. ‘Eureka’ moments are few and far between. Nonetheless, there will almost certainly be a moment in your research journey when you will realise that you now know something that no one, until that point in time, had ever really known for sure. And that, my friend, is the joy of discovery!