Diagnosis or Symbolic Assumption
To borrow from Robert Sapolsky in Behave : “Has medicine, in certain instances, yielded to symbolic reasoning rather than adhering strictly to scientific rigor?” I’ve come to a troubling realization: not every diagnosis faithfully corresponds to the underlying illness. Consider a familiar scenario. An adult patient presents with a cough and difficulty breathing. The doctor asks whether they smoke. “No.” “Are you exposed to secondhand smoke?” Again, no. At this point, one might expect a careful examination. Instead, a label is applied—sometimes forced into place, as if with a shoehorn and a strip of duct tape. The doctor prescribes an inhaler, assuming COPD. The treatment fails—not only because the diagnosis is incorrect, but because the patient experiences side effects such as trembling hands and heightened nervousness. At the next visit, rather than reassessing the initial assumption, a different medication is prescribed. By the third appointment, still without improvement, th...
