Heisenberg's uncertainty principle
M. A. Eastwood
Most of the physicians that I know are chary of Physics, especially the theory of elementary particles. Even if in Isaac Newton's mathematically precise universe, everything follows clear-cut laws and predictions are easy given appropriate starting conditions. Perhaps, however, physicians coping with this uncertainty will perhaps feel more in tune with Heisenberg's uncertainty law. Heisenberg (1901–76) described a theory of quantum mechanics, published in 1925, when he was only 23 years old. The uncertainty principle describes an imprecision in nature resulting in a limit to what we can know about the behaviour of quantum particles and, hence the smallest scales of nature. Heisenberg was awarded the Nobel Prize for Physics for 1932 for this theory and its application that resulted amongst other things the discovery of allotropic forms of hydrogen. His theory stated that we cannot always give an electron a position in space at a given time, nor follow it in its orbit, so that we cannot assume that the planetary orbits proposed by Niels Bohr exist. Mechanical quantities, such as position and velocity, should be represented, not by ordinary numbers, but by abstract mathematical structures called ‘matrices’ and he formulated his new theory in terms of matrix equations. The principle of uncertainty, says that the determination of the position and momentum of a mobile particle necessarily contains errors the product of which cannot be less than the quantum constant h and that, although these errors are negligible on the human scale, they cannot be ignored in studies. We cannot measure the position (x) and the momentum (p) of a particle with absolute precision. The more accurately we know one of these values, the less accurately we know the other. There are many ways of looking at this and in medicine we need to take account of uncertainty. Uncertainty in medicine can be resolved in many ways and can include Occam's razor. In medicine, all presenting symptoms in a patient may be explained by a few possible causes. In medicine, all presenting symptoms in a patient may be due to several disease and social processes at the same time. How can this be relevant to a working physician? The whole of medical practice has parallels with the certainties of Newton and Bohr. The object of a clinical consultation is to give a sign or complaint a diagnostic named description to be followed by a treatment regime which resolves the problem. Yet every physician knows and automatically models his understanding of a clinical problem perhaps unknowingly on a model based on Heisenberg's uncertainty principle. A core process, which is complicated by factors understood or not. The same principles are relevant to so many other features of life. There are certain fixed points in the diagnostic and clinical process. Gender, race, age, weight to height ratio, privileged and social life and intelligence. Some people age at different rates to their age cohort? Similarly, obesity does not always matter. The patient′s family history is another variable, complicated occasionally when the putative father with a family health trait may not be the actual father. The social story is a minefield, with the possibility of every phase of a person’s life being of relevance. A further element is how well the physician and the patient and their caring team relate. The clinical examination then gives a further array of data. From all of this comes a diagnosis which gives a pathway to a treatment schedule the ability of the patient to manage their treatment regime becomes important. There is a tendency that as soon as the diagnosis is made then the other elements fade away from the care plan, though of course it persists in the person's life. We are all consciously or unconsciously aware of the complex fabric of clinical care. It is intriguing to appreciate that other disciplines have been presented with the same multifactorial uncertainties. The era in Physics when Heisenberg introduced his view of nuclear physics was one when a precise physical model was being completed and gave certainty to a complex problem. His principle while obviously reintroducing uncertainty gave freedom of thinking and allowed further fruitful progress. We physicians do not enjoy uncertainty, and to have it formalized is uncomfortable. So we instinctively identify the major problem and treat that. By and large this is a useful process. It is however important to see this as a convenience. A convenience that may not always suit the patient. Applying the Heisenberg principles gives a broader view of a patient's concerns and problems and better care.
QJM•Nov 2, 2016•19 citations