08/07/2026
THE CHESS GAME OF THE BODY: WHY MEDICINE HAS SO FEW GRANDMASTERS
Three Levels of Seeing the Board
A beginner chess player looks at the board and sees the next move. The knight can go here, the bishop there. He reacts to what's directly in front of him, rarely looking beyond a single move. His game is a sequence of local, isolated decisions.
An experienced player thinks differently. He calculates combinations three, five, seven moves ahead. He sees not a single move but a chain of consequences: if I move the knight, my opponent will respond with the bishop, and then I can execute an exchange and gain an advantage in the endgame. This is no longer reaction but strategy — though strategy tied to a specific combination, a specific part of the board.
A grandmaster sees something else entirely. He perceives the board as a whole — not as a collection of pieces and squares, but as a single dynamic system where every element affects all the others simultaneously. A pawn structure on the queenside determines how safe the king is on the kingside. A weakness on one square will, ten moves later, become the reason for defeat in a completely different corner of the board. The grandmaster doesn't so much calculate moves as sense the architecture of the position as a whole.
Now in Medicine
A similar hierarchy of vision exists in clinical practice, though we rarely put it in these terms.
The first level is the doctor who treats the symptom. A headache — a painkiller. High blood pressure — a drug to lower it. Insomnia — a sleeping pill. This isn't stupidity or negligence: in many cases, this is exactly how first-line care should work, especially in acute conditions where the patient's condition needs to be relieved quickly. But when this approach is applied systematically to chronic conditions, the symptom is silenced while its source keeps running in the background.
The second level is represented by the rare doctor who seeks the underlying cause. He asks: why is this patient's blood pressure elevated? Perhaps it's insulin resistance, kidney dysfunction, or chronic stress with hypercortisolaemia. He runs a differential diagnosis, orders additional tests, tries to establish a causal chain. This already resembles playing several moves ahead — the doctor sees not just the piece but the combination that led to it.
But there's a limit here too: the cause is sought within a single organ system, a single specialty. A cardiologist looks for the cause in the cardiovascular system. A gastroenterologist — in the digestive system. An endocrinologist — in hormonal regulation. Each of them is an experienced player on his own section of the board, but a section of the board is not the whole board.
The third level — the genuinely "grandmaster" one — is rare, because modern medicine is structured in a way that almost precludes the very possibility of a holistic view.
Why Medicine Has Almost No Grandmasters
This isn't a matter of individual doctors lacking intelligence or qualifications. It's a matter of the system's architecture.
Medical education and subsequent practice are built on narrow specialization. This is a justified, and in some sense inevitable, response to the colossal volume of knowledge: it's impossible for one person to have equally deep expertise in nephrology, immunology, endocrinology, and gastroenterology at once. Specialization provides depth — but it takes away breadth.
The result is a systemic blindness that shows up in quite concrete ways:
• Iron deficiency is treated with iron supplements, but rarely does anyone systematically check the whole chain: pancreatic exocrine function and the malabsorption linked to it, inflammation levels and the role of hepcidin, interactions with other nutrients during absorption, or hidden blood loss.
• Chronic fatigue gets attributed to "stress" or "age," even though behind it may lie a combination of subclinical hypothyroidism, B12 and B9 deficiency, disrupted sleep, and low-grade chronic inflammation — no single factor critical on its own, but together creating a clinical picture that no individual specialist sees in isolation.
• Ascites in cancer patients is treated with diuretics and paracentesis, whereas a systemic view would require simultaneously accounting for protein metabolism, liver function, lymphatic drainage, and the metabolic interactions influencing the course of the underlying disease.
Each specialist plays a brilliant game on his own section of the board. But the patient is not a section of the board. The patient is the whole board — where a move made by an endocrinologist three years ago may determine the outcome of a game currently being played by a gastroenterologist.
Therefore, the patient often has to become the one who keeps the whole board in mind — comparing the opinions of different specialists, noticing connections that none of them can see in full, and piecing together a coherent game from a series of fragmented moves.
Ideally, an experienced doctor and a thoughtful patient could be perfect partners. So, what stands in their way?
