William Silverman

摘要

Bill Silverman, sometime professor of paediatrics at New York's Columbia University, knew what it was to be at loggerheads with his peers, which is perhaps not surprising when you recall his capacity to speak his mind "The impatient let's-try-it-and-see approach in the burgeoning field of neonatal medicine has resulted in therapeutic disaster after disaster," he wrote in a reflective memoir dated October 2003. His alternative was, of course, the randomised controlled trial (RCT). An early convert to the use of RCTs in obstetrics, Silverman remained a fervent advocate throughout a career that marked him out as one of the founders of American neonatal medicine. In 1945, as a newly appointed instructor in general paediatrics at Columbia, he encountered his most formative influence: New York Babies Hospital neonatologist Richard Day. It was Day who taught Silverman how to base his clinical care on science. Day's own willingness to admit uncertainty in the absence of firm evidence had opened his mind to Bradford Hill's seminal work on medical statistics. Silverman caught the same bug and, as he describes in the memoir already quoted—written on his 86th birthday at the behest of the James Lind Library (wwwjameslindlibrary.org/essays)— "the two of us were soon making nuisances of ourselves by criticising the 'in-my-experience' reasoning of our co-workers."