Rat Journals, Sturgeon’s Law and the Hawkins’ Corollary

Dear Winston

Ref: Rat Journals, Sturgeon’s Law and the Hawkins’ Corollary

Yes, I know I have mentioned Hawkins’ Law to you many times. And yes, you need to know what I mean.  I will answer that for you with a little background.  Have you heard of Sturgeon’s Law?

Sturgeon’s Law   “Ninety percent of everything is crap”

            Corollary 1:  “The existence of immense quantities of trash in science fiction is admitted and it is regrettable: but it is no more unnatural than the existence of trash anywhere.”

            Corollary 2:  “The best science fiction is as good as the best fiction in any field.”

Sturgeon was, early in his career, a science fiction writer and an editor of a science fiction magazine.  He received intense criticism for the quality of writing in science fiction and his response was what was to become known as Sturgeon’s Law.  References point out that others have had similar insights.

Voltaire in a short story,  “… but in all times, in all countries, and in all genres, the bad abounds, and the good is rare.”

Rudyard Kipling in the ‘The Light that Failed’,  “Four-fifths of everybody’s work must be bad. But the remnant is worth the trouble for its own sake.”

George Orwell in ‘Confessions of a book reviewer’,  ‘In much more than nine cases out of ten, the only objectively truthful criticism would be “ This book is worthless”.’

I initially encountered Joseph Hawkins, M.D, when I was first year resident in internal medicine at the University of Oklahoma.  At that time, Joe was the Consultant to the Army Surgeon General who oversaw assignments of duty stations for doctors going on active duty.  I was a recent draftee about to enter the US Army. 

Someone I knew in the Army had given me his name and the number of his office in Washington. I called him about my potential assignment on entering the Army, hoping not to go to Vietnam.  When I advised him that I would be a partially trained internal medicine specialist when I went on active duty and suggested I might be valuable at a major hospital, he laughed.  Joe gave me some sage advice.  He said I should consider entering an Army medical residency program to complete my training.  Probably the best advice I have ever been offered in my entire medical career.

Over a decade later, Joe and I found ourselves in Phoenix, in adjacent hospitals, in the same specialty – Pulmonary and Critical Care Medicine.  He was the director of fellowship training for our specialty at a regional teaching hospital and I was the director of the Pulmonary, Sleep and Critical Care services, at a hospital that helped with their training programs.  We shared training fellows and clinical experiences till his retirement.  

At our monthly journal club meetings, Joe would frequently ask. “What does the Rat journal have in it this month?”  One of our leading specialty journals had become focused on basic science research, departing from its decades long tradition of clinical based reporting.  For a time it frequently involved rats.  The journal became known to our group as the Rat Journal.  Practically all of its publications had little to do with the practice of medicine and most had little to do with significant advancements in sciences.

I believe the growing volume of medical literature is, and possible always has been, of little practical or insight value.  I would call it Hawkins’ Law or the Hawkins’ corollary to Sturgeon’s Law:  Ninety percent of medical research is crap.

As physicians, it is our burden and task to sort the information overload and find the 10%.  A firm foundation is needed in what is generally accepted knowledge, (knowing the current basic understanding of the medical disease, issue or problem) to judge how a new piece of information alters, changes or discounts our basic understanding.  Remember that the understanding of all human diseases will be further defined, changed, or altered during your medical career.  



Apr 23, 2022