"I thought, the way you solve a problem in biology is you solve its simplest representation."
Eric Kandel
My workshop ends with a lecture on “The Vitals of Pain.” This is the name I gave to five aspects of the patient’s presentation that I feel are essential to know and understand in order to proceed with evaluation and care. All of these are spoken of in one way or another throughout the day but I don’t have them listed specifically. Instead, I’d like to begin a thread that examines each of the five as well as my “End of Evaluation” concept.
To me, this view of evaluation and consequent care is the most important thing about my workshop but I’m not convinced many of my students see this. Perhaps this thread will help.
Let’s begin with the heretical notion that we should begin to spend less time and effort evaluating our patients. I know we’ve been pushed to consider, investigate and test for more as our knowledge of the body has grown, but for reasons Buchanan makes clear in “Ubiquity – The Science of History,” careful consideration of a multitude of factors in any complex system does us no good when we are attempting to understand and control it. This is especially true when it is in a critical state. See The End of Evaluation? for a detailed explanation of this reasoning.
The Kandel quote above says it all, and he won a Nobel Prize with this sort of minimalist approach. Not that I’ve any aspirations. But I ask just five questions of every patient to begin with and I thought it might be useful to present them here, one at a time. This should generate enough discussion to clarify these issues; maybe even change the nature of the questions themselves.
First Question: What is the origin of the pain?
How would you determine that?
Eric Kandel
My workshop ends with a lecture on “The Vitals of Pain.” This is the name I gave to five aspects of the patient’s presentation that I feel are essential to know and understand in order to proceed with evaluation and care. All of these are spoken of in one way or another throughout the day but I don’t have them listed specifically. Instead, I’d like to begin a thread that examines each of the five as well as my “End of Evaluation” concept.
To me, this view of evaluation and consequent care is the most important thing about my workshop but I’m not convinced many of my students see this. Perhaps this thread will help.
Let’s begin with the heretical notion that we should begin to spend less time and effort evaluating our patients. I know we’ve been pushed to consider, investigate and test for more as our knowledge of the body has grown, but for reasons Buchanan makes clear in “Ubiquity – The Science of History,” careful consideration of a multitude of factors in any complex system does us no good when we are attempting to understand and control it. This is especially true when it is in a critical state. See The End of Evaluation? for a detailed explanation of this reasoning.
The Kandel quote above says it all, and he won a Nobel Prize with this sort of minimalist approach. Not that I’ve any aspirations. But I ask just five questions of every patient to begin with and I thought it might be useful to present them here, one at a time. This should generate enough discussion to clarify these issues; maybe even change the nature of the questions themselves.
First Question: What is the origin of the pain?
How would you determine that?
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