To STUDY - Technical - New Dacian's Medicine
The New
Medicine 2020 - Introduction (7)
Translation draft
The time has come to discuss medicine in general (about the last
introductory material of this series "about medicine")...
The main objective will be the balance or imbalance that arises
when addressing a form of medicine when we do not "live" a
lifestyle that correlates the previously inferred "landmarks"
(body-mind-soul) and it comes to the more or less major
imbalance that makes us seek corrective intervention.
"What is this?" would be a logical first step. It's about you
and "Someone else." No one is born learned. Worse, we're
children, and we assimilate everything from our parents, from
the environment we evolve in. So the chances of something native
to exist, native teaching to be present, are undone by this
contact, in fact, by this need for adaptation to which we are
subjected. That," in terms of "material part." If we also take
into account the spiritual side, that it is a duty of fate, that
it is a necessity of "study", that it is everything else, things
get even more complicated.
So any step in a corrective intervention is necessarily
represented by contact with "someone else", with "something
else". This "someone else"/ "something else" can be the
environment, experiences, degree of knowledge, etc, and, last
but not least, a specialist. That we make contact with this
specialist through materials published by him, that we talk to
him, that we conform to his healing algorithms, what is
essential to remember is this contact is about something outside
of us.
Addressing the materialistic problem, this "specialist" is mom,
dad, grandmother, etc. who have had some tangencies to something
similar and have applied something similar, adapts to our
requirements, and reacts in a certain way, correctly or
incorrectly (we do not analyze this now). If the intervention
does not work, like any "adult", we proceed to change the
"doctor" (or one of those who "hold" our guardianship or
acceptance).
So, no matter what the customization, objective, by the way, it
goes to someone more and more specialized, thus becoming
ourselves small specialists in a given "problem". Hence the
perception that being a doctor (even another form of
specialist/qualified in the medical field) is a privilege,
allowing the patient to share the trouble, success, etc. with
the doctor, having maximum confidence in his judgment and
skills.
So here we come to the last conclusion "drawn" (in the previous
post)! The one where practicing medicine combines science with
art.
Starting from this, the first thing that stands out is...
Science. The role of science in medicine is clear, being the
element that "promotes" classical medicine above all other forms
of medicine. Forms that do not benefit from this "scientific
support" (they say), often being also the main factor by which
the other parties are blamed, become secondary, "helpful",
"witchy" (scams)...
Then, in the 21st century, the role and responsibilities of the
professional change rapidly, so defining what it means to be a
doctor (medical framework) is increasingly difficult. Moreover,
healthcare tends to be provided by teams, not individuals, as
well as other health professionals who now perform tasks in the
evaluation and management of patients who were previously
exclusively carried out by doctors.
There is also a massive advance in the use of artificial
intelligence using ever-wider sets of more or less sorted data,
represented by clinical, scientific, diagnostic/early selection
data (before the doctor's visit), the generation of diagnostic
and treatment algorithms, etc. The fact is that nothing is lost
from the crucial role of the doctor (medical staff), who is
challenged to accept collaboration with the new efforts.
And this not only in terms of collaboration with artificial
intelligence, such as operating assistance, the diagnostic
process increasingly augmented by artificial intelligence, etc.
but also in terms of the approach of all forms of medicine
scientifically proven over time, complementing the knowledge of
the ensemble thus formed (human-machine, of which the definition
is and will be a human).
Thus, science-based "technology" is the foundation of the
solution of many clinical problems, the amazing advances in
biochemical methodology and biophysical imaging technologies,
which allow access to the most distant depths of the body, being
the results of the progress of science and support for the
authority of medicine practiced on these bases. All science is
the basis for the ascent of therapeutic maneuvers which,
increasingly, constitute a major component of the current
medical practice (allopathic).
And, however, only skill in using the most sophisticated
laboratory technologies, intervention, monitoring (or others),
or the use of the latest therapeutic means, taken alone, does
not define a good doctor.
A good doctor must have skills that are no longer a science,
even if they can be put in the majority of the "scratch" of
it... Ability to extract from a lot of conflicting physical
signs and a cluster of laboratory data removed from the computer
display or printer those milestones that have crucial
significance, to know in a more or less difficult case whether
to "treat" or "supervise", to determine whether a clinical sign
should be taken into account or whether it should be ignored
because it leads to a "false track" and to estimate to each
patient if the proposed treatment involves a higher risk than
the disease, all these things intervene in the decisions that
the doctor, experienced or not in the practice of medicine, must
take every day. Added to all this is the patient's ability to
describe what he feels, what is happening inside him, and his
health...
So, here's a real first step in the balance with "Someone else."
It is a kind of need for real collaboration, a symbiosis between
the specialist and the person (and the people around him, people
who credit them with a certain level of knowledge and accept
their intervention) who seek help.
Then comes the doctor's ability to collaborate or collaborate
with the patient who is subjected to his interpretation of the
doctor or medical effort... In the care of the suffering, the
doctor needs technical skill, adequate knowledge, and human
understanding. And many, many more...
This combination of medical knowledge, intuition, and reasoning
constitutes what can be called "Medical Art". Art that depends
on technology, pharmacy, regulations, and laws, funds, etc. that
constitute other obstacles in the way of collaboration between
patient and doctor, between patient, and specialist.
Tact, compassion, and understanding are expected from a doctor,
for whom the patient is not some bundle of symptoms, signs,
altered functions, damaged organs, and emotional disorders. The
patient is a human being as full of fear (the attention that has
come to ask for help) as hopeful, seeking comfort, help and
encouragement.
It requires compassion, empathy, trust, respect, and humor,
traits that establish a relationship between human beings and
not a relationship between doctor and patient. Furthermore, an
ethical code was developed to ensure that the great power of
medical knowledge is used to the fullest possible for the good
of the patient and not necessarily of the doctor and society as
a whole.
The misanthrope can become a good diagnostician, especially if
he has "advanced" technology, but he can't hope to be successful
as a doctor because he can't have a complete horizon of
understanding, he can't be a doctor for the smart and the
stupid, and the vain and the humble, and for stoic heroes and
for the whining bums... He doesn't care about people...
He only cares about the placement in an elite of society, the
material advantages attracted by the practice of their
profession and, depending on the results of these strictly
personal desires, will prepare cold, mathematically, to increase
the number of figures in his account and not the number of
patients cured, will strictly respect the medical "normative"
even if he knows that this is not good for the patient but only
a compromise Etc... Or he'll migrate to another country
"injured" by his inability to act on his bank account...
Either, most of the time, the patient is either on the same
wavelength and people of the same sense of thought, experience,
etc. meet, or will feel the personal interest of the doctor and/
or his indifference and will give up (our luck that the vast
majority do not have much money requested by such specialists).
Here it is important that the patient quickly and completely
perceives all this and saves himself. By the way, here is the
case of those sick and not those who have acute problems that
certainly no matter how stinging it may be for the pocket, such
doctors can solve something. In "short distances" these
"specialists" resist being "pleasant and useful".
Returning to the logical course, the doctor must approach
patients not as "cases" or "diseases", but as individuals whose
problems, in their entirety, very often exceed the reasons that
brought them "to the doctor"...
So, once the diagnosis is established, human tasks continue.
Doctors will adapt their explanations to the needs and
understanding of their patients. Negotiate a treatment strategy
and share clinical decision-making with the person under their
care.
Either way, medicine will evolve in the future, at the heart of
everything we do. remains the huge privilege and pleasure to
care for, support, empower and help people so that their health
and social needs are optimally met.
Most patients are anxious and scared, often making great efforts
to convince themselves that the disease does not exist or
unconsciously put in place elaborate defenses to remove their
attention from the real problem, which they perceive to be
serious or life-threatening. Other patients use the disease to
attract attention or to emerge from a stressful emotional
situation, with some leading to simulating somatic diseases.
Whatever the patient's attitude, the doctor must take into
account the terrain on which a disease occurs, in terms that are
not only related to patients but also their families and social
conditions. All too often, studies and medical records fail to
include essential information about the patient's origin, degree
of schooling, work, home and family, hopes and fears (as, until
allopathic Western medicine is generalized, it was done under
the imposition of laws and regulations).
Without this data, it is difficult for the doctor to establish a
correct and real relationship with his patient, to penetrate the
"interior of the patient's disease". Thus, the doctor-patient
relationship ends up having to be considered as based on a
thorough knowledge of the patient, mutual trust, and the ability
to communicate with one another.
But nowadays, the direct relationship, from man to man, between
the patient and the doctor, that existed before the super
technology of medicine (current and future), is changing,
especially due to the conditions in which medicine came to be
practiced.
Often, the treatment of a patient requires the active
participation of a large, trained staff as well as several
doctors acting in the same spirit, which constantly requires
that each of them have an overview of the patient's problems and
who are familiar with the patient's reaction to the disease, the
drugs administered and the tests the patient is going through.
To meet this requirement of increasing difficulty, the doctor
must be familiar with the techniques, experience, and objectives
of other doctors and, to the same extent, those of colleagues in
the fields adjacent to medicine. Or, that's not going to
happen...
It should not be forgotten that practicing medicine in "special
care units" confers additional stress to the classical
doctor-patient relationship. Many doctors are themselves within
a limited time of discussion with the patient, limited access to
a specialist doctor, and organizational medical guidelines,
which can, over time, compromise their ability to exercise
optimal medical judgment.
These circumstances constitute an important request for the
doctor, who must carry out a quality medical act while
conforming to the organizational framework in which he practices
medicine. As difficult as these restrictions are, the doctor's
most important responsibility is to determine what is best for
patients, this responsibility cannot be abandoned in the name of
respecting the organizational framework (what happens en masse
nowadays when even the smallest medical structure is a component
of a financial/business and less medical "industry").
Or is it possible?!? A doctor who "feels" good treatment can
expose himself (allegations of malpractice, loss of years of
study, residency, compensation, freedom, etc.) applying "sick"
applying it if it does not exist in the procedures of colleges,
houses, etc. of doctors, practitioners, etc?!?
In addition, the diagnostic and treatment dilemmas of the
previously consulted practitioners should be observed (or
not?!?), the differences of opinion that occur in the treatment
of the patient are best resolved away from the patient.
All this irreversibly leads to a "cold" conclusion. The
specialists we turn to are becoming obliged to comply with
anything else less or to a very small extent to those who appeal
to them.
I don't think it is necessary to point out that many influences
in the contemporary world have the power to lead to the
depersonalization of health care. The most serious (in addition
to those already presented) is the intense efforts to reduce the
costs of health care, the growing confidence placed in
technological advances and computerization in many aspects of
diagnosis and treatment, the increased geographical mobility of
both patients and doctors, the growing number of health care
organizations, in which the patient has few options for choosing
the doctor and finally, but not least, there is a growing
tendency for patients to express their dissatisfaction with the
health care system by legal means (in this case through
professional disputes of poor practice - malpractice).
Therefore, it is now more important than ever that the doctor
considers each patient to be a unique individual, which deserves
to be treated humanely, without discrimination given by personal
or financial circumstances.
In conclusion, this "medical art" is necessary for a medical
practice to the same extent as fundamental scientific
principles.
He who uses his medical knowledge with modesty, courage, and
wisdom will offer his fellow man unparalleled support and build
a lasting edifice within him. The doctor must not ask destiny
for more than that, but nor should he be satisfied with less...
Finally, what would be the solution, as long as doctors
(specialists, practitioners, etc.) have their paths, further and
further away from us or, at least, increasingly neutral to the
patient's person (especially the difficult or "poor")?!?
The first solution would be to find a doctor dedicated to our
person, to our problem. Do you think that mothers or fathers
will find you on all roads (and here everything becomes more and
more doubtful over time)?!? So this is not the solution.
And, from my point of view, the solution is your access to
knowledge. Yes, you read well, you must know more and more! In
the medical world, there is, with purpose, a kind of saying: "In
the medical office almost always meet two experts: the doctor
and the patient". And, here's why...
The doctor, however good he may be, no matter how close his
connection to you may be, cannot replace you. It will not take
your disease, it will not make you follow a treatment, a way of
life, etc. The person who does this, consciously or not,
voluntarily or not, is you. So, what if you're the one who knows
exactly what to do and, in some cases, that we're not gods,
let's call a specialist. What would it be?!?
Of course, with reference only to acute "accident" cases.
Because that's all that's left once you know. Initially, it
would be a massive narrowing of the "needs" of aid. And, that's
because, first of all, you would find it very difficult to see
the existence of any disease, simply because of its
non-existence, and, secondly, because you would know what you
have, what disease you have (and no longer need a specialist),
the corrections will be applied by you and, in case of
"ignorance", you will get to inform the specialist about the
news you did not have access to.
Either way, you understand the point of this post. In any
"equation" you will enter your unknowns it is very important to
know at least one, the most important, You. This will follow in
my entire approach, to allow you to get to know you as well as
possible, possibly to know as much as possible about the problem
you have.
And, little by little, we are approaching a clear, indisputable
conclusion, related to the need to address the whole person and
not, one by one, the components that may occur in the process of
maintaining and/ or regaining the state of health, possibly
optimal, maximum, etc. of the somatic-mental-spiritual ensemble
of a single landmark individual...
Yes, it is something similar to the "baptism" of the basic idea
of our entire approach (or mine alone): the whole... And by no
means the private...
But until then we still have years and years of accumulating the
"molecules" that will constitute the whole knowledge that will
form the basis of our conclusions and, why not, our future
gestures, permitted or not by the capabilities, availability,
etc of the whole that has been made available to us for this
time and this dimension...
Next time (when it will be)!!!
Happy birthday to all the Joans and Johns!!!!
Bibliography:
1. Harrison - Treaty of Internal Medicine (Harrison's Principles of Internal Medicine), XIV Edition, Teora Publishing House, 2010.
2. Kumar and Clark Internal Medicine - Adam Feather, David Randall, Mona Waterhouse, X edition, Hippocrates Publishing House, 2021.
3. Diagnosing Your Health
Symptoms for Dummies - Knut Schroeder, Wiley Publishing, 2010.
3. A Guide to the Evaluation
of Common Adult and Pediatric Symptoms - Wasson, John H.;
B. Timothy; LaBreque, Mary C,; Sox, Harold C.; Pantell Robert,
5th Edition, McGraw-Hill Publishing, 2002.
4. An Atlas of Headache - Parthenon Publishing, 2002.