More Art Than Science

Mid-Summer                                                                              Waxing Honey Flow Moon

Gotta get back to those core exercises.  Back went ouch again today.  Sympathy for the Doctor?

Healing is much less science and much more art.  Most of us see medicine covered in the glittering wrap of science, tested hypotheses, proven procedures, well-understood drugs, but in fact the science is often in deep background during a patient-physician encounter; where the most important work, diagnoses, is done often without the patient’s awareness.  Diagnoses, taking a given person with a particular list of symptoms and identifying what’s actually causing a problem, begins a this/not that path that then includes various treatment protocols.

Will they work?  No certainty.  My former internist, Charlie Petersen, used to say, “We’re all  a bit of a black box inside.”  The difficulty faced by the physician is not only the variability in human bodies, but the inexact reporting of patients.  We often don’t know how to express ourselves to the doctor, aren’t always aware of what’s important and what’s not.  Ask anyone who thought that headache and funny vision would pass, then ended up in an ER getting treated for a stroke.

I experienced this dilemma with Kona.  She presented with a right front leg held gingerly and a real grimacing when it moved.  I checked her front leg, feeling up and down its length, pressing at each point to see if there was a sprain or a break.  Nothing.  I felt no scars, found no blood.  I wasn’t sure what had happened but could find nothing wrong.  I never looked up and under her right shoulder where the wound was obvious.  I took her lead, followed the symptom she presented.  Doctors, of course, look beyond the first symptoms we present, but if we don’t mention something, they’ll not know to check.

It occurred to me, given all this, that practicing medicine is an incredibly brave thing to do.  No one knows the limitations of western medicine more than physicians, yet they show up in exam rooms anyway, willing to use what they know to benefit the rest of us.  They work with us as knowledgeable experts, of course, but also as skilled listeners, both to our stories and our bodies.  The older I get the more respect I have for this, one of the oldest professions.

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