leukemia case

[Guest guest]

I'd like to underscore (in hindsight, admittedly) Z'ev's point that the

peeled tongue and fast pulse suggested deeper pathology right from the

outset. I initially thought that the tongue dx must be wrong, since red

is common in kids I see, but not peeled. Of course, the suspicion of

leukemia, which commonly leads to damaged fluids even before it

manifests acute lymphadenopathy, confirmed the relevance of this sign.

Given the etiology, blood stag from trauma was a reasonable first hunch,

but it is worth noting that other tumors are often found as a

coincidence to a local trauma, especially testicular cancers. Knowing

Jacob's thoroughness on his own patients, I suspect he would have

changed his mind in a more thorough intake, as I hope I would have as

well.

 

However, I am not sure what intuition had to do with the correct dx of

this case or how it might have helped. I think Jacob and Zev both make

it clear that not enough information was gathered and key signs were

ignored. If all the info had been gathered and analyzed carefully, then

no error would have been made. The solution to this " mistake " , in my

opinion, would have been more rational assessment of the case, not

reliance on hunches or feelings, which is he common meaning of

intuition.

 

However, there is also the psychologist's or philosopher's definition of

intuition. Intuition is not an alternative to logic (i.e.

intuition=feelings/body and logic=thought/mind). Intuition is a faculty

that transcends but includes logic, feelings and sensations. Intuition

does not tap into knowledge from the universe or the patient's bodymind.

It is a higher level organization of the thoughts and perceptions of

one's own mind. Thus, if we fail to gather enough data or if we

misinterpet the data, no feeling will substitute for that deficiency.

 

When we discussed this before, I think it was generally agreed at that

time that the so-called " intuition " of student practititoners and recent

grads was often wrong in that it could not be supported with evidence

after the fact and the clinical results were generally unsatisfactory.

And that the best way to cultivate one's intuition, especially with

regard to herbalism, involves considerable study of texts, including

classics, as well as practices that enhance development of one's

consciousness (yoga, tai ji, etc.).

 

Intuiton, as I have defined it, should arise as a natural part of the

developmental process of human beings, just like language, ego formation

and advanced cognitive skills. There is nothing mystical about it.

However, I do believe we must be careful not to mistake our fleeting

emotions, feelings or sensations for this higher level intuition. When

one is young, like me, I think the only way we can be sure of our

intuitions is to test their logic after the fact. So if I suspect liver

depression in my gut, I must justify it in my mind before proceeding.

there is certainly no harm in doing this and the patients deserve this

double check.