THESE days, while the economy is the hot topic and David Stockman the rising star, I find it difficult to concentrate on medical grand rounds. The usual sense of guilt over not being fully devoted to medicine lingers. That is, until a visiting professor at a recent grand rounds began his elaborate discussion on the "forward" vs "backward" hypotheses of ascites formation. Then, eureka! It came to me, the realization that economy and medicine do mix, that the case presented of advanced liver cirrhosis with refractory ascites is indeed a metaphor for our national economic problems.
Economics is a profession in double jeopardy: on the one hand, the accuracy in predicting future trends often is no better than the weatherman's forecast. On the other hand, the economist, like the physician, is burdened by opposing hypotheses. There are at least two reasons why such opposing views coexist in economics and medicine.