{"id":2350,"date":"2019-01-28T11:45:44","date_gmt":"2019-01-28T11:45:44","guid":{"rendered":"https:\/\/aurelis.org\/blog\/?p=2350"},"modified":"2019-01-28T11:45:44","modified_gmt":"2019-01-28T11:45:44","slug":"a-disease-is-a-continuum-not-an-entity","status":"publish","type":"post","link":"https:\/\/aurelis.org\/blog\/healthcare\/a-disease-is-a-continuum-not-an-entity","title":{"rendered":"A Disease is a Continuum, Not an Entity"},"content":{"rendered":"

Medical textbooks generally list diseases as crisp entities. This may be OK in a book, providing exemplars of reality. However, real reality is different. This has several far-reaching consequences.<\/h3>\n

To be or not to be?<\/strong><\/p><\/blockquote>\n

Many diseases \u2013 if not all \u2013 are not binary conditions. To be or not to be, is not the proper question in this regard. Instead, there is a continuum from \u2018healthy\u2019 to \u2018more and more diseased\u2019, for almost any kind of disease. Most people are healthy and at the same time slightly off on the continuum towards a number of what could be called \u2018diseases\u2019 further on this continuum.<\/p>\n

Yet the thinking, including that of probably most physicians, is quite binary. Meaning: the diagnosis is given or not given. The disease is deemed to be either present or not present. The medication or other therapy is deemed to be appropriate or not appropriate. If appropriate, it\u2019s deemed to have a specific posology: \u201ctake these pills three times each day for 7 days.\u201d<\/p>\n

Organic<\/strong><\/p><\/blockquote>\n

Binary thinking co-creates a binary world. This is easier to deal with but it is less realistic. Organic creatures mostly do not live binary lives by nature. They are not \u2018ill or not ill\u2019.<\/p>\n

Instead of this, organic reality is \u2018multi-vectorial\u2019. Meaning: we live on continua from normal to quite abnormal, from healthy to diseased in many directions at the same time. In addition to this, we continually glide on these continua from here to there and back again. In other words: \u2018one big mess\u2019.<\/p>\n

And yet this is not<\/u> problematic<\/strong><\/p><\/blockquote>\n

It\u2019s just what life is. It\u2019s what keeps us alive. What appears to be a mess, is actually a kind of ecosystem of continua. As with other ecosystems, they provide feedback to each other, thus keeping the whole going in a livable direction\u2026 until it ends of course. A limitation called \u2018death\u2019.<\/p>\n

But before that event, the system is generally very robust. If an equilibrium gets distorted on one or the other of the \u2018vectors\u2019 (continua towards illness), the whole ecosystem reacts in such a way that the distortion gets readily resolved. The whole is much<\/em> stronger than the sum of the elements.<\/p>\n

Repercussions on the concept of \u2018disease\u2019<\/strong><\/p><\/blockquote>\n

These go far.<\/p>\n

In medical textbooks, quantitative characterizations of diseases are mostly handled very fuzzily. It\u2019s quite weird that this goes much further than the mainstream physician has \u2018knowledge of\u2019. Yet it\u2019s plainly there. You just have to open such a textbook and see.<\/p>\n

For instance, I open one and read \u2018patient being quite red in the face\u2019. What is \u2018quite\u2019? What is \u2018red\u2019? What even is \u2018the face\u2019 exactly? That is not specified. Yet research shows that readers (physicians) have very disparate interpretations. Meanwhile, even the textbook writers themselves work in an unrealistically binary mode of thinking. I know. I have been one.<\/p>\n

Of course, this doesn\u2019t diminish the diagnostic correctness of exemplary cases. However, it points to very<\/em> fuzzy boundaries. Thus, reality contains much more continua than crisp domains of specific disease.<\/p>\n

This also sheds different light on comorbidity (two diseases at the same time), huge cultural variations in symptomatology, the degree to which mind can easily be abstracted away from many \u2018diseases\u2019 etc.<\/p>\n

No diagnosis in AURELIS<\/strong><\/p><\/blockquote>\n

There are a lot of \u2018health domains\u2019 in AURELIS. Yet it is not appropriate for any AURELIS coach to pose a diagnosis. Medico-legally, this is the safest option. Moreover, this blog points to an even much deeper reason to stay clear from diagnosing. I hope it\u2019s clear to any reader.<\/p>\n

As a first approximation, the specific \u2018health domains\u2019 in AURELIS are entry points towards the just described continua. Transcending this, they are foremostly entries towards the \u2018person as a whole\u2019. This is VERY logical within AURELIS philosophy.<\/p>\n

Thus, an AURELIS health domain is not only appropriate with the \u2018correct diagnosis\u2019. For instance, a physician might provide a specific diagnosis, then change it. The use of AURELIS as pointed to the abandoned diagnosis, is not therefore irrelevant. It may even be equally appropriate to use \/ keep using that domain. It depends on the user as a unique individual.<\/p>\n

Because in the end of course, it\u2019s about people, not about textbooks.<\/p>\n

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Medical textbooks generally list diseases as crisp entities. This may be OK in a book, providing exemplars of reality. However, real reality is different. This has several far-reaching consequences. To be or not to be? Many diseases \u2013 if not all \u2013 are not binary conditions. To be or not to be, is not the Read the full article…<\/a><\/p>\n

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