For more than a century, the electrocardiogram has served as medicine's quiet cartographer of the heart — tracing its electrical life in waves and intervals. Now, scientists at Scripps Research have published a model called ECG-CLIP that learns to read those traces the way a seasoned clinician does: not by memorizing millions of labeled examples, but by first grasping the underlying physiology and then recognizing a new disease from as few as a dozen cases. Trained on 1.7 million ECGs paired with physicians' own clinical reasoning, the model matches or surpasses existing tools while requiring