At year end, we typically engage in a retrospective examination, looking back on events and trying to make sense of them. Simultaneously, there is a human instinct to make predictions as well as resolutions, both of which are notoriously unreliable. The notion of predicting the future is one that is inherent in medicine by virtue of the fundamental role of a physician to make a diagnosis, but also concomitantly a prognosis (fore-knowledge) about the patient’s clinical course. After many years in Psychiatry, I have become very cautious about predicting outcome and have relied much more heavily on clinical follow-up and retrospective reviews. This applies also to the task of doing retrospective capacity assessments which many are still skeptical about. Yet, there are in fact many advantages of a retrospective assessment that can cast a sharper relief on symptoms and behaviours that were not entirely clear at a contemporaneous examination. A thorough retrospective assessment may indeed be better than a poorly conducted contemporaneous examination.
Some famous quotes about the future are revealing:
1. “Prediction is very difficult, especially if it is about the future” – Nils Bohr, Nobel Laureate in Physics
2. “The best qualification of a prophet is to have a good memory” – Marquis of Halifax.
3. “The future is like a corridor into which we can only see the light coming from behind” – Edward Weyer, Jr.
These quotes highlight the importance of memory and retrospective perspectives when thinking of what is ahead. We know that hindsight is 20/20. We know that “those who do not know history are condemned to repeat it”. So why don’t we place more emphasis on knowing history and looking back? All of this suggests that at year-end, we should pay more attention to what has taken place as we prepare for an uncertain future. It leaves us in a humble state of mind as we look forward and look back at 2015.
Best wishes to all for the New Year.