On wondering

Wondering is a cousin of curiosity and the parent of inventiveness. Almost everything learned in the course of professional education and in the processes of professional life has been discovered or developed because of wondering. A host of creative individuals once wondered in ways that made today's medicine possible, and make the medicine of tomorrow feasible. Wondering is also integral to clinical decision making in general, to diagnosis, therapeutic choices, and management priorities. It is central to broader themes and to opportunities to seek the larger issues of which the daily problems of clinical practice and research are manifestations. Oddly enough, it is important to decide to wonder in this way to harvest its benefits. It is useful to identify one or two big things to wonder about from time to time to use as bases for the development of fractals of interest and professional growth. The author discusses in depth two such opportunities for wondering, both of which concern issues that underlie the immediate clinical event: (1) why individuals' health, disease outcomes, and life expectancy vary, and (2) why disease patterns change. He concludes that developing a capacity for wondering exercises the mind and the spirit, broadens the horizon, and in the long run is not only good for the doctor but also for his or her patients, for patients to come, and for the health of the profession itself, because it opens the door to change.