I retired from clinical medicine on February 7, 2020. Four days later, the WHO gave the name “Covid-19” to the virus causing the pandemic. I had been a hospital consultant for nearly twenty-four years, specialising in gastroenterology, but also doing “general” medicine. I had many plans for the first months of my “new life”, and like everyone else, I have had to re-calibrate my expectations. Now, I start each day with a five-mile walk, a circle around the small rural village where I live. I often meet neighbours on this walk, and since February, there has only been one topic of conversation. Even though I am retired, and have little or no expertise in virology or epidemiology, my neighbours always respectfully seek my opinion on developments with the pandemic. Irish country people still have an old-fashioned deference to the professions; or maybe they are just being kind, bolstering the self-esteem of an old(ish) man no longer at the front-line.
The phrases I hear myself saying are usually: “I don’t really know”; “I’m not sure” and “I’m not sure anyone knows”. A journalist friend phoned me several weeks ago, and was disappointed when I told him that having retired from active practice, I didn’t have a feel for what was happening at the front-line, that most of what I knew came from news media. “Yes, yes”, he said impatiently, “but you’re an acknowledged expert in medicine.” I had to think about this. Do I now have expertise in anything? This prompted me to re-read Harry Collins’s short 2014 book Are We All Scientific Experts Now?, which I reviewed at the time for the Dublin Review of Books. If you haven’t heard of this book, I strongly recommend it. Collins, a professor of social sciences at Cardiff University, is a sociologist of science, and an expert on expertise; he has studied gravitational wave physicists as Margaret Mead studied Samoans.
In my work as a gastroenterologist, I was – according to Collins’s classification of expertise – a “contributory” expert:
A contributory expert is someone who makes a contribution to an area of expertise and is, generally, what people think of when they hear the word ‘expert’. How does one become a contributory expert? By working with other contributory experts and picking up their skills and techniques – their tacit knowledge of how to do things. One become a contributory expert by being an apprentice.
Although I might persuade a judge hearing a medical negligence case that I am still an “expert”, as far as I and my former gastroenterology colleagues are concerned, I ceased to be a contributory expert the minute I drove out the back gate of Cork University Hospital on February 7th.
Then there is “interactional” expertise, which according to Collins “is acquired by engaging in the spoken discourse of an expert community to the point of fluency but without participating in the practical activities or deliberately contributing to those activities.” Collins himself, having studied gravitational wave physicists for decades, is familiar with most of the concepts they discuss; he is thus an “interactional” expert, but because he doesn’t actually do gravitational wave physics, he is not a “contributory” expert. Finally, there is “meta-expertise”: “used to judge and choose between other experts; in principle, this kind of expertise can be good enough to guide one through the decisions one has to make in the contemporary technological world.” I used to think that I possessed this expertise, but with the infodemic that has closely followed the pandemic, I’m not so sure.