No black or white<\/strong><\/p>\n\n\n\n Few people really think there is only one possible cause for each disease. Pragmatically however, many people act as if finding a cause is the end of the meaningful causal search.<\/p>\n\n\n\n Including physicians.<\/p>\n\n\n\n Being pragmatical<\/strong><\/p>\n\n\n\n With the cause found, proper management should be at bay \u2015 at least frequently. Why would one keep thinking about many possibilities if the patient needs his therapy now?<\/p>\n\n\n\n Of course, being pragmatic is a serious argument in healthcare. Apart from this, \u2018doing something\u2019 is a serious endeavor. One wants to help or be helped. Indeed. But would you likewise go to the train station and take just any train when you need to catch yours?<\/p>\n\n\n\n I guess not. In many cases, it pays to know whether the direction is correct. This is very practical knowledge \u2015 depending on available time and resources.<\/p>\n\n\n\n Many diseases are multicausal<\/strong><\/p>\n\n\n\n Not only potentially, as in textbooks, but in concrete cases with actually ill patients. For instance, an infection may be caused by a germ, but why does one person get sick and not another? The immune system plays a substantial role \u2015 sometimes the biggest- making it more evidently \u2018the cause\u2019 than the germ. At this point, physicians may shout, \u2018Of course!\u2019 before reading the next question.<\/p>\n\n\n\n How large is the immune system\u2019s role generally without a specific immune disorder? How large are its fluctuations due to temporary factors? Add to this my preferred question: How large is the role of the psyche in how the immune system \u2013 and the body in general \u2013 reacts to the germinal attack?<\/p>\n\n\n\n If large, then diagnosis \u2013 and therapy \u2013 should take this strongly into account.<\/p>\n\n\n\n Whirlpool-causality<\/strong><\/p>\n\n\n\n The whirlpool causal principle is seldom or never discussed in medical textbooks. In my view, this is a huge gap in our understanding of how people get ill and then get better again. The whirlpool principle may be relevant to most<\/em> cases that get into the doctor\u2019s office.<\/p>\n\n\n\n The reason is that we are complex organisms, not simple (or complicated) mechanisms<\/a>. In complexity, many elements interact in intricate loops. These interactions usually stabilize the organism (allostasis, homeostasis) within a complex environment. But sometimes, the interactions get out of hand in self-enhancing feedback loops. Once inside, things get increasingly out of hand until the person becomes severely ill or may even die. What we call \u2018illness\u2019 may be primarily the result of getting into such loops in most cases<\/em>. Thus, not the individual elements are causal, but the whirlpool is.<\/p>\n\n\n\n This is not exclusively relevant to the mind. However, the mind happens to be our most complex asset. Thus, one can expect complexity-related phenomena in this respect<\/a>, such as gastric ulcer<\/a>s and COVID-19<\/a>. Generally, the underlying principle may be an acute stress whammy on the basis of a chronically predisposed organism (chronic stress, depression, burnout, anxiety). Such mind elements may be present in the whirlpool together with body elements.<\/p>\n\n\n\n The future will clarify this<\/strong><\/p>\n\n\n\n Science will probably \u2013 with the use of A.I.-tools \u2013 show a lot of what we are missing right under our noses. This way, we are evolving toward a realistic picture of a whirlpool of disease<\/a>.<\/p>\n\n\n\n Lisa <\/a>can be an excellent tool in this endeavor.<\/p>\n\n\n\n <\/p>\n