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This article is adapted from “The AI Revolution in Medicine: GPT-4 and Beyond,” by Peter Lee, Carey Goldberg, and Isaac Kohane, published by Pearson.

“Thrashing.” That’s what old-school computer scientists called it when an operating system is running so many tasks at once that just switching among them basically crashes it. And that’s how I felt last fall when I tested GPT-4, the far more powerful successor to ChatGPT, on medical challenges for the first time. I was caught in a stuttering stasis between two competing, nearly overwhelming realizations.


On the one hand, here I was having a sophisticated medical conversation with an artificial intelligence platform that, I knew for a fact, knew nothing explicitly about medicine. (In contrast, I spent much of my youth earning an M.D., as well as a Ph.D. in computer science.) All it did was compute the next word in a sequence of words in our conversation. That such a “know-nothing” process could engage in a conversation about a diagnostic dilemma, hormonal regulation, and organ development in a way that 99 percent of practicing physicians could not keep up with was mind-blowing.

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