“I am a Claude and she’s a ChatGPT.”

I have been writing a blog (PallMEDPrep) for the past year and the number of posts is about to reach the double century mark. There is this nagging, gnawing and perhaps slightly disturbing realization that the deeper I delve into my writing and the more critically I reflect upon my ideas, the more I may be in danger of losing my sole authorship. This has forced me to contemplate the origins of my writings. Convention dictates that one bounces ideas off colleagues. That is often how authorship remains in danger of being defined. Well in the absence of like-minded consorts and perhaps by virtue of being a lone ranger, as is the case with Palliatrists, I have been going back and forth with my preferred Artificial Intelligence tool with some alarming regularity.

At what point does the AI tool assume the role of a co-contributor?

I am being forced to trace the evolution of my progress as an author and the impact of AI on my clinical decision making, in order for me to answer this.

I have been taught that my patient related concerns are supposed to conform to a certain pre-decided narrative. I have come across various attempts to stereotype my thought process and skill set into a box, for the purpose of employment, and for the want of a word – conformity. That my patient, who seems inherently different from the expectation of someone with advanced disease, is supposed to be looked at with the same lens as in the west, a setting which is a more evolved and resource intensive than mine. Should I attempt to contort my thought process because I am not able to distill the needs of my patients into a subject-specific category?

My protestations which populate my writings have been unable to find a home. My systemic critiques have been blunted by the threat of a lack of a position, which every postgraduate in this field can be expected to face. There has also been an attempt to create a narrative populated by token criticisms, which treat assimilation into an environment as a loss of one’s intellectual uniqueness.

My postgraduate training had been characterized by a lack of allegiance to a single tome. My inability to found a specific text, on which to anchor my knowledge led to accessing various standard texts from Medicine, oncology and other subspecialties (majority of them online). While this was encouraged and led me to various conferences and a respectable quantum of passing marks, the backlash towards making these incursions and vocalizing my support for improving the quality of education was palpable, during most of my interviews.

I started writing the blog as an extension of my communication with the vast compendium of materials which addressed issues in my patients, but had not found their way into a standard text, as yet. And due in part, to the palpable absence of these queries in the questions of various interviewers, who refused to move beyond service development. I had to keep reminding myself, that the patients around me required considerations for interventions that could be considered the domain of various subspecialties. And in the absence of a system that had refused to provide them with care concordant to their needs, in advanced disease, I had to take the call. An inaction at my end could mean a failure to correct the correctable.

I came to writing with the attempt to explore the legitimacy of my clinical decisions after the realization that I required the assistance of expertise not available to me readily. To question my own decisions and in order to scrutinize them, I required assistance from Artificial Intelligence tools (a fearless co-journeyman that could be expected to approach clinical decision making with no preconceived ideas of boundary crossing or subject specific ownership of the patient). To me it was an intermediary, that was reducing the amount of work in eyeballing various available sources before zeroing in on standard literature suited to a particular topic. Perhaps subconsciously, I was adding a new member to my non-existent team.

Was I doing the right thing? Was this considered to be acceptable at this stage in my career? There have been these occasional urges to somehow, remove the AI related disclaimer. Why not position yourself as an intellectual phenomenon, a prodigy even. However, I am yet to take the bait. Aren’t specialists (and now a consultant) expected to be rattling off dosages and references off the cuff. Well, maybe they are. And, perhaps a Palliatrist by virtue of the complexity of his work is simply not destined to be that kind of a specialist.

I was discussing the answers to multiple choice questions for the SCE exam with a junior colleague the other day (I may be finally in the process of justifying the inclusion of my name in a list of MASCC-certified Mentors). Yeah, even she has been forced into this rhetoric eager to label Palliative medicine as a broad specialty and sidestep its complexities, one which is to be dispensed hurriedly without prior Internal Medicine training and faces similar challenge. During the to-and-fro of top secret knowledge, I came across the realization that we were being forced to take recourse to Generative AI in order to understand the nuances of UK-based practice which is expected to form the basis of specific questions.

The concluding line to this treatise, crossed my mind instantly and I thought to myself, Perhaps, I am a Claude and she’s a ChatGPT. So are our intellectual identities in danger of being redefined by allegiance to an AI tool? Will it in the not so distant future define how we describe our qualifications (MD Claude-aided or MRCP Chat GPT-inclusive)?

Now, that might indeed be a profound question!!

P.S. Miraculously, no AI tools were used during the conceptual development and process of publication of this piece.

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Conspicuous. Absent.