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PostPosted: Tue Nov 07, 2017 7:52 pm 
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Nanohedron wrote:
... besides, these people actually do seem genuinely motivated to lessen suffering, and so far as I can see they have done me nothing but good, to the best of their abilities.


But of course. I don't mean that they mean you harm, but every doctor knows that patients, as a whole, need to have confidence that their doctor knows what he's doing. If they lose it, nothing works - they don't take their meds, they go looking for naturopaths and faith healers, they get discouraged and give up. Bad news all round. So, they learn to feign a certainty they might not always feel, and they're rarely completely candid.

Everyone feels like an imposter sometimes, or gets discouraged about how effective they're being. Medical practitioners learn to keep up the mask of professionalism, and to never let a patient see inside this facade.

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PostPosted: Tue Nov 07, 2017 8:19 pm 
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s1m0n wrote:
So, [physicians] learn to feign a certainty they might not always feel, and they're rarely completely candid.

Everyone feels like an imposter sometimes, or gets discouraged about how effective they're being. Medical practitioners learn to keep up the mask of professionalism, and to never let a patient see inside this facade.

Sure, I get that. I may be your nonstandard patient in this, but I even expect and prefer the normal human condition, because I'd be more worried about a doctor that had only certainties. That would be scary. I don't think we should concern ourselves too much with the façade, or whether there even is one. As you say, it's bedside manner, and that's part of good medical practice. But as for uncertainties: I don't know about your practitioners, but to date, if mine aren't entirely sure about the best way to proceed and are entering into consultation for that reason, they let me in on that. Whether this revelation of uncertainty be cause for worry to the patient or not, I would go so far as to expect that such disclosures are in fact, by regulation, required of the doctor. Even my own opinions and decisions have on occasion been solicited. I'm invited into the process, and I definitely don't get the feeling I'm hostage to jealous authority. I do know from experience that that mindset exists, but so far I haven't come across any of that here. There's been your grouchy tech or two, but so much for façades in that case.

Really, s1m0n, sometimes I think you just like to sow doubt for the sport of it. :wink:

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PostPosted: Tue Nov 07, 2017 8:54 pm 
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Nanohedron wrote:
Really, s1m0n, sometimes I think you just like to sow doubt for the sport of it.


That's interesting. To me, what just happened is that you recounted an anecdote in which two practitioners, confronted with a direct and specific question, gave vague and perhaps evasive answers. To be specific, the doctor was vague and the nurse evasive. It intrigued me enough to wonder why this might be so, and brief thought provided several possible explanations for this behaviour. I don't see this as sowing doubt in the slightest. To me, it's understanding people.

If you analyse the doc's response, it's both very certain and totally vague. That's characteristic. Show no weakness.

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And now there was no doubt that the trees were really moving - moving in and out through one another as if in a complicated country dance. ('And I suppose,' thought Lucy, 'when trees dance, it must be a very, very country dance indeed.')

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Last edited by s1m0n on Tue Nov 07, 2017 9:05 pm, edited 1 time in total.

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PostPosted: Tue Nov 07, 2017 9:05 pm 
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Ah, that's very interesting! To me, their responses were not evasive at all, but the opposite. Now I'm fascinated. I've always taken it as a given that none of us see the world in the same way, but now here's big proof. :)

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PostPosted: Tue Nov 07, 2017 9:08 pm 
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Nanohedron wrote:
Ah, that's very interesting! To me, their responses were not evasive at all, but the opposite.


She ignored your question and covered it with a laugh. How is that not evasive?

Nanohedron wrote:
I asked her about the claim that stethoscopes were outmoded in cardiology and hardly in use if at all, and she laughed.

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PostPosted: Tue Nov 07, 2017 9:14 pm 
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I think what's missing here may be an omission on my part, and for that, mea culpa: The nurse laughed, but didn't just leave it at that, if that's what you're thinking. Of course she had a bit to say about it, too (I didn't think the fact that she had a comment needed saying), but what more can be said than the claim wasn't true? We both were on the clock. I think you're entirely off the mark to color things by saying she ignored my question and covered it with a diversion, but then you didn't have all the details you apparently needed, either, so there's that. To me, it was simply an honest response. There IS room for that, you know. Likewise, I can't take the doctor's comment as vague, at least on purpose. It may not come jam-packed with all the justifications that would entertain and satisfy a curious mind, but all the same, what he said was good enough for me. Look, I trust these people. Why shouldn't I?

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PostPosted: Tue Nov 07, 2017 9:51 pm 
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Fair enough. I can only go on the information I have. But what I want to say is that in a situation like this, I am rarely sh!t-disturbing. Most of the time, I'm trying to understand other people as complicated people with complex motives. Humans, in other words. Everyone deserves to be understood as a human being. To me, this is an act of love, or at least caritas, not an attack.

One of my chief intellectual pursuits is to observe unusual behaviour and to try to model the kind of thinking that it would take to make me behave that way.

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And now there was no doubt that the trees were really moving - moving in and out through one another as if in a complicated country dance. ('And I suppose,' thought Lucy, 'when trees dance, it must be a very, very country dance indeed.')

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PostPosted: Tue Nov 07, 2017 10:25 pm 
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s1m0n wrote:
To me, this is an act of love, or at least caritas, not an attack.

Ah.

s1m0n wrote:
One of my chief intellectual pursuits is to observe unusual behaviour and to try to model the kind of thinking that it would take to make me behave that way.

If this is directly related to your interpretation of the aforementioned laugh response, the modeling exercise is fun, but it risks operating solely on conjecture, in which case it would say less definitively of them than it would hold up a mirror, in fact, to you. Allowing that you might still be right, here's my interpretation for comparison: They weren't evading me at all. They were laughing at the idea because it was so blatantly ridiculous, rather than being nervous about my question. This was not about me, so there was nothing to make me feel I'd gotten the brush-off. The idea wasn't my idea, after all, and my impartiality was evident enough. I had no stake in it; it was simply because the idea sounded so outlandish, I wanted to see what the horse's mouth had to say about its substance or lack thereof, and got the response I actually suspected I'd get all along. Rather than evaded, I felt vindicated and actually rather relieved. Different viewpoints, indeed.

I really don't think anyone was killing the messenger, here. :)

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PostPosted: Tue Nov 07, 2017 11:15 pm 
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Yes, of course it's conjecture. That's where the fun lies. If my conclusions were certain, they'd be no fun at all.

Every field has its essence. Or essences, because there are several. Mine is English Literature, and one essence is that studying lit is expert training in drawing conclusions on the basis of insufficient evidence. Other fields, like science and (to a considerably lessor extent) law demand convincing evidence, but lit is very little interested in clear cut cases. Instead, what intrigues us is the murky middle ground. We learn to muster evidence and argue cases where the truth could lie at either hand. If the answer to a question is clear or obvious, none of us cares. Someone will have worked that out years ago. What's intriguing are questions where the evidence is ambiguous, but you have to find your way through to some kind of conclusion(s) regardless. This is what lit training excels at. We're experts in doubt and conjecture.

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And now there was no doubt that the trees were really moving - moving in and out through one another as if in a complicated country dance. ('And I suppose,' thought Lucy, 'when trees dance, it must be a very, very country dance indeed.')

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PostPosted: Wed Nov 08, 2017 5:38 am 
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Wow. A lot can happen when one is away from C&F for 24 hours. It was a good read though. :thumbsup:

Regarding the stethoscopes: Nano, I am glad that it seems you had fun and got to test your theory. However, two employees at one hospital is not a sufficient sample size to say that the article is wrong. I would also argue that the article isn't claiming that the stethoscope is useless now, but that its importance in diagnosis is decreasing and it is gaining more prominence and functionality as a symbol.

...

Also, the fact that your doctor is not using a tricorder already shows that they aren't innovative. :P


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PostPosted: Wed Nov 08, 2017 6:30 am 
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On further consideration, I would also propose that stethoscopes are more useful for heart and lung doctors than most other doctors. So your data sample may be overly biased.


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PostPosted: Wed Nov 08, 2017 7:00 am 
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s1m0n wrote:
We're experts in doubt and conjecture.
Whilst the sparring match is entertaining the stethoscope article seems to allow much more scope for picking holes that does Nano's his first-hand account.


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PostPosted: Wed Nov 08, 2017 10:22 am 
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david_h wrote:
s1m0n wrote:
We're experts in doubt and conjecture.
Whilst the sparring match is entertaining the stethoscope article seems to allow much more scope for picking holes that does Nano's his first-hand account.


Prolly, but I didn't read it.

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PostPosted: Wed Nov 08, 2017 1:30 pm 
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s1m0n wrote:
Yes, of course it's conjecture. That's where the fun lies. If my conclusions were certain, they'd be no fun at all.

Every field has its essence. Or essences, because there are several. Mine is English Literature, and one essence is that studying lit is expert training in drawing conclusions on the basis of insufficient evidence. Other fields, like science and (to a considerably lessor extent) law demand convincing evidence, but lit is very little interested in clear cut cases. Instead, what intrigues us is the murky middle ground. We learn to muster evidence and argue cases where the truth could lie at either hand. If the answer to a question is clear or obvious, none of us cares. Someone will have worked that out years ago. What's intriguing are questions where the evidence is ambiguous, but you have to find your way through to some kind of conclusion(s) regardless. This is what lit training excels at. We're experts in doubt and conjecture.

On the basis of this conversation, I'm afraid I find no outcrop I can moor my boat to with this expertise you speak of, or at least your presentation of it. What you have done is arrive at and impose rigid conclusions (I would say mistaken ones) about my story. Then you backpedal saying it's merely a literary exercise, but if so, it doesn't indicate to me any readiness to really entertain all the possible realities of an actual moment in life itself, and to me the proof of this is that you have nothing whatsoever to say about my own interpretation. In fact, you seem to avoid it. What I see instead is no flexibility for any viewpoint other than your own prejudices, so the claim of "exercise" (my word, of course, not yours) frankly rings a bit hollow for me. You postulate from the outset that everyone in the medical profession operates from a siege mentality born of an adversarial relationship to the patient, but that is the only thing you seem to be able to latch onto despite clear evidence of compassion on their part. What about that? You only acknowledge this when your back's against the wall; the rest of the time you stop just short of saying it's an outright sham. I don't find this willful omission and innuendo to be expert at all, but see it as the traces only of a perennially suspicious mind. Just because I'm not suspicious, it doesn't follow that I'm not a thinker. Make no mistake about that. I do indeed arrive at my own conclusions, and not just out of blind reflex.

As the man said, sometimes a cigar is just a cigar.

AaronFW wrote:
However, two employees at one hospital is not a sufficient sample size to say that the article is wrong.

And that must be said. OTOH, I've also lived long enough to recognize the general reliability of the maxim that where there's smoke, there's fire. :)

AaronFW wrote:
I would also argue that the article isn't claiming that the stethoscope is useless now, but that its importance in diagnosis is decreasing and it is gaining more prominence and functionality as a symbol.

The problem for me is that the article didn't say that in so many words. Your interpretation is better nuanced, and I appreciate and give you that, but when the article makes sweeping claims that the latest generation of doctors don't know how to use stethoscopes and only make a show of it for psychological purposes, to say that my credulity is strained to the max is putting mildly.

Really, at this point we would need an actual practitioner's input here to better inform, if not settle, the matter.

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PostPosted: Wed Nov 08, 2017 3:18 pm 
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Nanohedron wrote:
...but when the article makes claims that the latest generation of doctors don't know how to use stethoscopes and only make a show of it for psychological purposes, to say that my credulity is strained to the max is putting mildly.


I can't see med schools ignoring stethescope training completely, if only for the sake of their grads who might go practice in lower tech places, but they might well be training new doctors to rely more heavily on technology.

In any case, unless your cardiologist is of this generation, his opinion on the question is irrelevant.

AaronFW wrote:
However, two employees at one hospital is not a sufficient sample size to say that the article is wrong.


The nurse is going to use the equipment her boss uses, if only because he controls the equipment budget, so really, the sample size is 1.

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