One of the “medicine” newsfeeds, perhaps reacting to Biden’s transition to non-governmental pursuit of cancer, was describing how the new strategy, divided between two academic locations, will be to record all the genomes of cancers (which necessarily means their hosts) in all their incredibly multiple variations and then smush them up in the computer to see if there are commonalities. This represents a huge paradigm shift in the way sophisticated moderns see the world. I come to it from biology and Tim comes to it through physics.
We change focus from defined entities to tiny particles in dynamic relationship and locate reality in the PROCESS, not the one-by-one chunks we think are real. A person is a process, a planet is a process, all the stars of the galaxies are processes. They don’t hold still. If the process stops, the molecules begin to come apart in order to start a new process, but — of course — the coming apart is also a process. You can get with it or oppose it, but it will go on anyway. It’s like politics.
When I say biology, my particular focus is my own physiology, but not at the level of genomes. Instead I’m looking at what medicine calls “syndromes.” Some of us who have what’s called Diabetes 2, have already understood that it is a “metabolism syndrome”; that is an interaction of the mechanisms of metabolizing food (especially sugar), regulating blood pressure, and the accumulation of belly fat. We know they happen together, usually as we age, but not what the pathways and causes are.
https://www.nhlbi.nih.gov/health/health-topics/topics/ms This is the official version, but you may have noticed how much “official versions” are a process and a reversible one — that is, what’s forbidden today may be perfectly okay tomorrow. Minorities become authorities. So I just go ahead with my coffee and butter, but cigarette smoking as a hazard is clear enough that I don’t. It has not reversed — it’s still bad.
When I first began to have symptoms of Sjogren’s Syndrome, my eye doc was baffled. It was August and we decided it was because there was so much smoke in the air. But then later he noticed a patchy place on my cheek and asked about rosacea. Now my diagnosis became ocular rosasea. Years ago my diagnosis was ocular migraine. Clearly, they are related to the management of fluids, esp. in the face, and so that’s how I got to Sjogren’s.
My docs don’t have the luxury of sitting at the keyboard searching and then pondering the results, so I have gotten in the habit of running off info and sending it to be put in my folders. I don’t know whether they do it. They are dependent on the folders, but the actual papers are managed by kids barely out of community college and not particularly worldly. That’s a process problem. It’s because the kids can manage the transitions back and forth from paper to computer files.
This is the best I’ve found about Sjogrens: http://www.uptodate.com/contents/sjogrens-syndrome-beyond-the-basics The thinking now is that one inherits the risk. My mother had “dry eye syndrome” and always accumulated mucus in nose/sinuses overnight. The first sound I heard in the morning was often her “hawking and spitting”. I have never figured out how to “hawk” and often have glitches in the back of my throat which I ascribe to an over-inclusive tonsillectomy and adenoid removal back in the Fifties when this was considered a cure-all. I choke and strangle easily.
But then there must be a trigger for the syndrome which is supplied for many of us by computer screens, staring without blinking. All this can be managed by using drops, cleaning the mineral deposits (in my case) off the eyelids’ lashline morning and evening, and the use of a neti pot to clear sinuses, etc. The trouble (again for me) is that I wake up, go directly to the computer, and often don’t stand up until noon, not even to change to day clothes. (One ankle swells when I sit like this.) This is probably a syndrome, meaning a whirl in the process that isn’t helpful to health.
What plagues me now is forgetfulness. It doesn’t approach dementia but I make little cards, checklists, of things I’m supposed to do when I get up and when I go to bed, what to take when I drive to a bigger town to shop, including, of course, my shopping list which I consistently forget. But even when I was in my twenties, Bob made me wear a little notebook on a ribbon around my neck, and write down all the stuff I was supposed to do in the shop. Today I carry around a notebook in which I record many things. It’s as much a matter of being preoccupied as a memory failure.
I’m careful to write down in it the notes from conversations with techies, whose names I always include. I realize that all doctors are techies and that they believe each other far more than they believe me. They are taking notes on their end — I hear their keyboards clicking.
The doctor I had in Portland before 1999 was a heart specialist who did by-pass surgeries. They had become outmoded when optical fiber intervention worked better and he was too old to have the necessary dexterity. He was a respected man with a high ethical standard, but he saw everything through the lens of someone who did heart surgery. He could not diagnose my diabetes, my plantar fascitis, or my eye problems. After I moved back to Montana and asked for my file to be sent to ME instead of the next doc, which he did not want to do and edited before he sent it, I discovered he had written that I had congestive heart failure. I knew he had offered me meds for angina though I didn’t have any angina symptoms. I knew that when I complained of some other symptoms he would leave for a while with no explanation. I realize now that he was either looking through his reference books (which were dated) or calling a colleague. But when I googled congestive heart failure, it was enough of a worry to haunt me ever since as well as influencing decisions.
When I went to a female doctor here, she believed the congestive heart failure, saw signs of it that weren’t real (I was wearing men’s black compressive socks because they stay up), decided I was denying and evading, and treated me so aggressively for diabetes that I nearly drove off the road on the way home.
Misdiagnosis is a process and when the practice manager limits diagnostic interviews to a short time and delegates intake to near-teenagers, the process becomes the victim of a syndrome that needs a name. (Greed syndrome?)
The difference between looking for what was irritating my eyes (an allergy) and recognizing a body-wide syndrome is subtle, but can mean a difference in meds as well as my own ability to build in monitoring and compensation. If the process can be delayed (Sjogren’s can expand to lupus, lymphoma, rheumatoid arthritis and other things), comfort as one moves towards death will be much helped. I think we are too death-focused: that’s the end of the process. Pushing away death through imposing suffering is not a choice I would make. We would do better to understand the processes, not just our own but how we fit into the whirls of the cosmos.