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Needed: A Coherent Architecture for 21st‑Century Clinical Practice and Medical Education
We need to build a new foundation for 21st century medicine. The architecture for 20th-century organ-system medicine was not designed to accommodate both the robustness of traditional medical principles and wisdom and the riches that have poured from the biomolecular sciences in the last half-century. The 21st century heralds the entrance into the life sciences of the systems-biology model that has been evolving rapidly over the last 20 years, 1 compelling us to address the notion of pervasive networks that link the mechanisms of both health and disease: everything is connected to everything, in a coherent wholeness.* If we look and listen, we can perceive everywhere a continuous dynamic dance in which the various elements never stand still or exist in solitude.2-4 The search for one gene–one-disease answers has given way to concepts of gene networks and bidirectional epigenetic vectors that sum to phenotypic expressions of health and disease. The answer to the quantum mechanics EPR Paradox5 (Einstein-Podolsky-Rosen,1935) has arrived: there is experimental proof6,7 that the unfathomable uncertainty of the behavior of electrons is real (God apparently does play dice),8 and uncertainty and quantum phenomena are now foundational concepts that must be accommodated in our scientific and medical principles and practices.