The History of Medicine Through the Fractal 4 METs
How a simple structure has shaped — and can now transform — healthcare.
From Healers to Systems
In the earliest days of medicine, healing was personal. Knowledge passed directly from healer to patient, often through oral tradition and apprenticeship. Care was guided by close observation, intuition, and lived experience. While this intimacy created deep trust, it also meant there was little consistency and limited ability to share knowledge beyond small communities.
From Craft to Profession
The printing press, scientific revolution, and early universities transformed medicine from a craft into a profession. Medical education became more formalized, knowledge more widely available, and methods more consistent. The foundation was laid for systematic approaches to care — though these systems were still slow to change and often isolated from one another.
From Generalists to Specialists
Advances in science and technology drove medicine into an age of specialization. Each new discovery created the need for deeper expertise. While specialization allowed for incredible progress in diagnosis and treatment, it also introduced new challenges: fragmentation of care, communication gaps, and loss of a unifying framework for decision-making.
Four Essential Questions — Across Time
Throughout history, the core challenges of medicine can be reduced to four questions:
1. Who are you, and who are you becoming?
2. Why now?
3. Do we know what we’re doing?
4. When are we leaving, where are we going, and who cares?
These questions have always been present — whether implicitly in the mind of a village healer, or explicitly in the protocols of a modern surgical team.
Fractal Thinking Brings It Together
What has been missing until now is the ability to define these questions with precise operational meaning and embed them in a fractal, recursive structure that can operate at every scale — patient, team, system, or nation. The concept is timeless; the capability is entirely new.