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 have come to a troubling realization: not every diagnosis accurately reflects the underlying illness. Consider a familiar scenario. An adult patient presents with a cough and difficulty breathing. The physician asks whether the patient smokes. “No.” “Are you exposed to secondhand smoke?” Again, no. At that point, one might expect a careful examination. Instead, a diagnostic label is applied prematurely, and medication is prescribed on the basis of assumption—perhaps COPD, perhaps a bronchial infection. The treatment fails because the underlying diagnosis is incorrect. Worse still, the patient may experience adverse effects from the prescribed inhaler, such as trembling hands or heightened nervousness; in some cases, younger patients may even develop sudden incontinence. At the next visit, rather than reassessing the or...