Dénouement

The saying goes, "ontogeny recapitulates phylogeny" and it is within the context of this complex biologic process that all is made clear and the sequence of life becomes a fully realized entity. Humans are, after all are a product of all the elements, chemicals and influences that have occurred in our lives. Our abilities, our weaknesses, our inspirations and the forces that plot our downfall and demise are wrapped up in a giant primordial stew of events and subplots that help mold and shape us and then follow our course through life to continue the process minute by minute until the very end.

Philosophy is not my strong suit but I can appreciate the applications of this phrase as I sit in front of my patients charts, trying to sort out my daily decisions for their health and safety. Medicine as a science and the daily practice of patient care commits a doctor to a life of endless decisions, the assumption of often agonizing risk and the constant need to plot solutions, redefine boundaries and negotiate skillful contracts and detailed instructions with patients. A doctor cannot practice medicine simply by decree or by force of will. There are too many elements to the patient's story and there are too many forces that are at work that impact on the successful outcome of a treatment strategy. If ontogeny really is the process that an organism passes through to achieve it's evolution then our human story and the final dénouement are also part of that process. It is the job of the physician to steward that journey to a successful outcome.

The theory of recapitulation, also called 'the biogenetic law' or 'embryological parallelism', and often expressed as ontogeny recapitulates phylogeny, was put forward by Étienne Serres in 1824–26 as what became known as the "Meckel-Serres Law" which attempted to provide a link between comparative embryology and a "pattern of unification" in the organic world. In 1866, the German zoologist Ernst Haeckel proposed that the embryonal development of an individual organism (its ontogeny) followed the same path as the evolutionary history of its species (its phylogeny).

Reference: Wickepedia

de·noue·ment (also dé·noue·ment)
a. The final resolution or clarification of a dramatic or narrative plot.
b. The events following the climax of a drama or novel in which such a resolution or clarification takes place.
2. The outcome of a sequence of events; the end result.