Rheumatic Diseases and the Heart

What medicine lacks in an increasingly specialised world is the medical polymath (or should it be medical bimath?) - the man who is an acknowledged expert in more than one field of medicine. Superpecialisation in the professional sense is an attempt to know more and more about less and less. It can be the microscopist's view of reality and such a microcosm can become also a refuge from realities. One reality difficult for the very specialised doctor to accept is that diseases don't exist. Only people with diseases exist and people do not always conform to convenient categories and compartments. It would be nice if they did but somehow they never do. A cherished medical tradition in Britain is that specialists are not hatched straight from medical schools. Indeed, young doctors are actively discouraged from taking too narrow an interest but are plunged for at least four years into the unspecific pool of general medicine until they have developed a broad awareness of the totality of human disease. Before this they are not allowed to narrow their sights on one particular target.