I get troubled looks from psychiatry residents when I point out that our field is the domain of the uncertain and the not-well-understood — and that it will always remain so. As soon as the cause of a disease is known, it automatically leaves psychiatry for another specialty. ...Confident pronouncements of certainty have no place in psychiatry. Humility is the only honest attitude to take. The questions we face are fascinating, patients are suffering, and neither can wait for definitive knowledge. We must do the best we can with imperfect knowledge, with limited data and educated guesses, with hunches and subtle impressions.