The Usual Symptoms

Published: 22 July 2026

Author(s): Gabriel de Paula

The Sieve of Reasonability

Pharma isn’t short of great ideas, but the best ones are never realised. This is because, before they get to the field, they must pass through the Sieve of Reasonability.

It’s a concept borrowed from a poem by GK Chesterton (who was definitely not talking about pharma) and describes a mechanism that ‘rattles reason out through many a sieve / that stores the sand and lets the gold go free’. This is exactly what happens with provocative insights in our industry.

Take this one that came from one of Impatient Health’s own Medical-focussed workshops: ‘patients don’t need reassurance, they need permission to expect more’.

We can trace how an insight like this one travels down the layers of pharma’s Sieve of Reasonability with confidence.