You cannot see the whole sky through a bamboo tube Japanese proverb

Not long ago I was asked to prepare an article for a science magazine issue that was to focus on the trust humans place in science, and how important that trust was (and is) during the COVID-19 pandemic. Reflecting on trust in science during the initial phases of the COVID-19 pandemic, I realized that even people who tend to embrace science completely were often perplexed by the wide variety of studies and reports and disparate recommendations that arose from many quarters. Most veterinary staff experienced similar confusion as we dealt with the questions, angst, and alarm many of our clients express(ed) regarding the possibility of COVID-19 spreading to humans from their pets, and vice versa. This at a time when there was not a lot of certainty about answers to those questions. Initially, most people had to trust the messenger more than the message (trust the scientist more than the science), until enough data could be acquired, and a clearer understanding achieved.

As evidence-based medical practitioners, we depend on scientific rigor to inform our recommendations, decisions, and actions. At the same time, we know that science is a way of measuring rather than a way of understanding; that science is a tool that does quite well to answer “How, What, Where and When” (all requiring critical interpretation), but not to answer “Why?” (ditto). Those of us who are diagnosticians also realize that the questions asked in formulating a diagnostic or therapeutic plan can be even more important than answers on which we base our decisions.

Whereas veterinary medicine is an evidence-based science, veterinary practice is more than that. Hence The CVJ publishes a series called “The Art of Private Veterinary Practice.” Even so-called “alternative medicine” can become “evidence-based” when tried, tested as true, and accepted into mainstream. Just as certainly, some “alternative viewpoints” can become verified and trusted over time. The challenge is, learning something new or changing one viewpoint requires abandoning or altering previously held ones. Sometimes those views are very tightly held and protected, even without evidence to support them. We see this in our society with individual approaches to the concept of vaccination against COVID-19. We see the same principle in our daily work as diagnosticians when we are called to integrate many sources of diagnostic information into recommendations for animals owned by people who often have their own tightly grasped and cherished viewpoints.

We live in a world of wonders, a complex place in which emerging concerns and new developments can both challenge us and give us immense opportunity for growth, development, and innovation (in both knowledge and viewpoints). Sometimes medical professionals suffer from a certain hubris in thinking we know a lot, based on our educational background and experience. But if you are like me, we have learned from both clients and their animals that more factual knowledge does not necessarily mean more understanding. It helps to realize that no one experience of reality can contain the whole reality, and the reality of our clients and their animals may look very different to them than it does to us. In many cases I find that discrepant viewpoints are not mutually exclusive but that together they offer opportunity for a more inclusive, enhanced understanding.

I recently read a fascinating and beautiful book titled “Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge and the Teachings of Plants,” by Robin Wall Kimmerer. Dr. Kimmerer is an American Distinguished Teaching Professor of Environmental and Forest Biology, and Director of the Center for Native peoples and the Environment, at the State University of New York College of Environmental Science and Forestry. She is a member of the Citizen Potawatomi Nation, which has a population of almost 30 000 in Canada and United States. In a section of her book in which she shares a worldview of Indigenous Peoples, she writes, “When I stare too long at the world with science eyes, I see an afterimage of traditional knowledge. Might science and traditional knowledge be purple and yellow to one another, might they be goldenrod and asters? We see the world more fully when we use both.” (1)

We would be wise to heed the message of this fellow One Health practitioner as we integrate scientific knowledge and personal viewpoints into the art of our veterinary practice.