There are theoretically endless possibilities for what may be troubling the patient but, in most cases, the probabilities restrict these options to but a handful of potential diagnoses lobbying for your attention and, of those, one or two, perhaps three, viable alternatives for what may actually be wrong with the person in front of you at that moment.
Diagnosis is a spiritual encounter; an encounter within a transcendent moment of space-time for which the clinician ought let all their senses decide what the situation is trying to tell, what it is saying, rather than a clinician’s personal agenda, whatever be its nature, acknowledged or otherwise, recognised or not, dictate to the situation and force-fit a diagnosis to the presentation.
In essence, this is a phenomenological approach to diagnosis, an approach where the diagnosis is allowed to reveal itself to the clinician whose eyes and ears are open.
Once mastery of the theories of the discipline of medicine is gained, the various permutation and combination of clinical presentation appreciated, it is then time to let the spirit awaken to each encounter.
The patient, the situation, the parents, the witness, whoever it may be, will reveal to you the diagnosis, whispering it in silent if only you are willing to listen. This is the art of medicine and the art of reading between the lines, and it comes with experience and patience and a nurturing of spiritual senses. This is what it means to be in the moment, to let the situation, no matter how urgent, reveal its own nature and extent. Let it fully realise its force and features, let it speak, and then let the clinician react and respond accordingly.
Indeed, each diagnostic moment presents an aura all its own, an aura to tap into. When the aura is tapped into a diagnosis is not made; rather, the diagnosis speaks and it says its name.
The atmosphere about the patient retains the true nature of the history, even where the patient themselves finds difficulty in translating it. Let the ambience of the moment guide the clinician’s intuition to the point of the truth of a matter.
Hone in on the point of inscription of origin that relates the history as it unfolded. Every history with its own teleology driven by its own entropy. Let the energy of that system be the decisive moment of guidance: the energy that cannot be created nor destroyed, only changed in its form. Tap into that energy and work backwards to pinpoint the originary lesion, then forward to appreciate the time-course of event that guides therapy not only qualitatively but also the speed of its response. A response commensurate to the time-course of insult to the individual’s physiology.
Distill the nature of the complaint into its philosophical essence and in a way that will guide treatment. This is the essence of being in the land of the living; learning from the energy of the system that each individual partakes in. That energy does not lie; rather, it records all truth. The truth is the abstract principle that summons the contingent complexities and lays them bare. A truth to be reckoned with.
