{"id":641,"date":"2020-06-16T08:22:00","date_gmt":"2020-06-16T12:22:00","guid":{"rendered":"http:\/\/www.sahilnawab.com\/blog\/?p=641"},"modified":"2020-06-16T13:34:02","modified_gmt":"2020-06-16T17:34:02","slug":"moving-away-from-nosology","status":"publish","type":"post","link":"http:\/\/www.sahilnawab.com\/blog\/moving-away-from-nosology\/","title":{"rendered":"Moving Away from Nosology"},"content":{"rendered":"\n

Medicine is a privileged field. Every day, patients place their trust and lives in the hands of physicians. As a result, physicians have a responsibility to society, and that includes being aware of their own biases<\/a> and mitigating their effects.<\/p>\n\n\n\n

Nosology: the branch of medicine that deals with the classification of diseases<\/p><\/blockquote>\n\n\n\n

Despite this, disparities exist. For example, black women are much more likely to suffer from complications during childbirth. Even more troubling, is that they are also less likely to be listened to by doctors.<\/p>\n\n\n\n

On Sept. 2, the day after giving birth to her daughter via cesarean section, Ms. Williams was having trouble breathing and \u201cimmediately assumed she was having another pulmonary embolism,\u201d the article says.<\/p>

She alerted a nurse to what she felt was happening in her body and asked for a CT scan and a blood thinner, but the nurse suggested that pain medication had perhaps left Ms. Williams confused, according to Vogue. Ms. Williams insisted, but a doctor instead performed an ultrasound of her legs.<\/p>

\u201cI was like, a Doppler? I told you, I need a CT scan and a heparin drip,\u201d Ms. Williams, 36, said she told the medical team.<\/p>

When the ultrasound revealed nothing, she underwent a CT scan, which showed several small blood clots in her lungs. She was immediately put on the heparin drip. \u201cI was like, listen to Dr. Williams!\u201d she told the doctors.<\/p>Maya Salam<\/cite><\/blockquote>\n\n\n\n

Athletes like Serena Williams are particularly tuned in and aware of their bodies. Of anyone, they would be most likely to understand when things feel wrong or abnormal.<\/p>\n\n\n\n

There is a movement to move medicine and the role of the physician away from the age-old idea of the nosologist. Medicine in the past was about the heroic physician-scientist; the idea that doctors are there to solve puzzles, make diagnoses, classify diseases, rather than treat patients. That job is supposedly for nurses and other healthcare professionals. That philosophy of medicine is slowly going away, as medicine as a whole is becoming more humanistic and empathetic<\/a>.<\/p>\n\n\n\n

There is still a long way to go. However, I think we are on the right path and are continuing to move forward. Ultimately, it is important to recognize that it is our human experience that brings us together. While physicians are certainly not immune from bias, they take pride in being able to recognize that patients come in with complex and nuanced issues, including the social determinants of health.<\/p>\n\n\n\n

Hospitals are one of the very few places left where you encounter the whole span of society. Walking the halls, you begin to understand that the average American is someone who has a high-school education<\/a> and thirty thousand dollars a year<\/a> in per-capita earnings, out of which thirty per cent<\/a> goes to taxes and another thirty per cent to housing and health-care<\/a> costs. [. . .]<\/p>

Most people don\u2019t have this broad vantage. We all occupy our own bubbles. Trust in others, even our neighbors, is at an historic low<\/a>. Much of society has become like an airplane boarding line, with different rights and privileges for zones one to ninety-seven, depending on your wealth, frequent-flier miles, credit rating, and S.A.T. scores; and many of those in line think\u2014though no one likes to admit it\u2014that they deserve what they have more than the others behind them. Then the boarding agent catches some people from zone eighty-four jumping ahead of the people in zone fifty-seven, and all hell breaks loose.<\/p>

Insisting that people are equally worthy of respect is an especially challenging idea today. In medicine, you see people who are troublesome in every way: the complainer, the person with the unfriendly tone, the unwitting bigot, the guy who, as they say, makes \u201cpoor life choices.\u201d People can be untrustworthy, even scary. When they\u2019re an actual threat\u2014as the inmate was for my chief resident\u2014you have to walk away. But you will also see lots of people whom you might have written off prove generous, caring, resourceful, brilliant. You don\u2019t have to like or trust everyone to believe their lives are worth preserving.<\/p>

[. . .]<\/p>

I didn\u2019t understand him or like him. But all it took to see his humanity\u2014to be able to treat him\u2014was to supply that tiny bit of openness and curiosity.<\/p>Atul Gawande<\/cite><\/blockquote>\n\n\n\n

Dossier<\/strong><\/p>\n\n\n\n

“Curiosity and What Equality Really Means,” by Atul Gawande, June 2, 2018. https:\/\/www.newyorker.com\/news\/news-desk\/curiosity-and-the-prisoner<\/a><\/p>\n\n\n\n

“For Serena Williams, Childbirth Was a Harrowing Ordeal. She’s Not Alone,” by Maya Salam, January 11, 2018. https:\/\/www.nytimes.com\/2018\/01\/11\/sports\/tennis\/serena-williams-baby-vogue.html<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Medicine is a privileged field. Every day, patients place their trust and lives in the hands of physicians. As a result, physicians have a responsibility to society, and that includes being aware of their own biases and mitigating their effects. Nosology: the branch of medicine that deals with the classification of diseases Despite this, disparities […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-641","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"aioseo_notices":[],"amp_enabled":true,"_links":{"self":[{"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/posts\/641","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/comments?post=641"}],"version-history":[{"count":3,"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/posts\/641\/revisions"}],"predecessor-version":[{"id":770,"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/posts\/641\/revisions\/770"}],"wp:attachment":[{"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/media?parent=641"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/categories?post=641"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.sahilnawab.com\/blog\/wp-json\/wp\/v2\/tags?post=641"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}