History can seem contradictory, a clash with itself. When it does, I urge you not to think that you’ve been tricked, conned, or hoodwinked. Look a little longer and you’ll likely find that two diametrically opposed facts can co-exist. A major health news event from yesterday will show the truth of my point.

Avastin is a drug often used to treat women with breast cancer. As a mark of the drug’s popularity, in just 2010 alone, Avastin produced $6 billion in sales for its manufacturer, Genentech, a part of the global healthcare company Roche.
The news event from yesterday was that a special panel of the U.S. Food and Drug Administration (FDA) denied regulatory approval for the drug in continued use against breast cancer. 

And here’s where my point about history’s clash with itself comes in.
According to the FDA’s special panel, tests of Avastin had shown that on average statistically, the drug had not produced any more than a “month or so of progression-free survival” for patients. However, Genentech argued that thousands of documented individual cases revealed two-, three-, and even five-year additions to life-spans when the drug was used.

In both instances, that of formal tests and that of individual cases, history was at work. The production of a statistical average of time in formal studies was an expression of history, of time past, elapsed, and captured. And yet, the individual case histories were exactly that, too—history organized as a set with multiple members. There it is: history in the former and history in the latter, both pointing the same way but in opposite directions. History is in the aggregate as well as the distinctive.

I have two parting thoughts for you. First, realize that in your use of history you need to know when you’re looking at the aggregate and the distinctive. If you mix them without understanding you’ve done so the near-certain result will be bad analyses and worse decisions. Second, at some point you might hear about me helping medical doctors strengthen their grasp of history in their approach to patient case histories. I think there’s much for a physician to gain in applying a creative understanding of history to his or her handling of patient cases.