Psychology phenomena ladder

Basically, psychological diseases such as anxiety/depression and phobias/manias may not be regarded as diseases but rather merely as psychological phenomena. This is because of two reasons: 1) they can be experienced by almost all people (then it is quite embarrassing to find all people psychologically ill) and 2) they can happen in varying degrees and in different time lapses.

The origin of psychological disease/phenomenon seems to be the specific set of characters that the person builds up from the very beginning of life and throughout life especially during the first few years. This argument may be supported by the assumption/observation that certain psychological conditions would be experienced by some persons in some life stages but not by others in the same life stages. For examples, anxiety would me more in young adults with little experiences who tend to be sensitive (good-spirited and ambitious) and righteous, while depression may be more experienced by materialistic (intellectual and chance chasing) and self-centred persons.

Such naturalizing of psychological diseases/ phenomena would, from one side, reduce the emotional burden given by those experiences, and revise the significance/role of medical treatment of psychological conditions, from the other side. Indeed, nonmedical or conservative treatment would be the general rule while the medical treatment may be needed only on occasional basis. However, every psychological case should be considered individually and the treatment plan should be, hence, very specific for that person.

As the extent of psychological experiences varies in terms of obviousness/picture, duration and pattern, those experiences may be ordered in a ladder of ascending phenomenal grades. Although that view would implicitly mean a mode of diseases/condition evolution, neither the relay between stages nor the completion of the whole track may be strict.

This scheme sheds light on the importance of the insight of the person as a determinant for favourable/unfavourable psychological path. It implies also the role of the person’s will, i.e. choice – to a certain degree – as to where to direct his/her emotional and spiritual investment.


Factor 10 disease

factor 10 disease

1- Disease classification: a kind of psychosomatic disease (review disease classification here).
2- Disease description:
Type of patient: young adults and middle age, male > female
Symptoms and signs
The person may c/o usually unrelated symptoms that my include
– unjustified mood change, e.g. depression
– laziness, fatigue, drowsiness, malaise
– defective concentration, haziness
– muscle cramps, pain, heaviness
– intolerance to drink enough water, waterphobia
– intolerance to cold or hot weather
– emotional instability
– maybe some degree of lack of judgment, hesitation
Vital signs
body temperature: may be slightly decreased
pulse: can be slightly increased, high normal
blood pressure: tends to be lower average range
Disease onset: gradual or insidious
Disease course: intermittent or chronic
Prognosis: variable, according to person’s attitude
Investigations: usually normal
Treatment and prevention: according to disease chart
3- Disease chart
Movement —> 50%
Emotion —> 50%
Agent —> 0%
Work engagement —> 33%
Food and drink —> 33%
Hygiene —> 33%
4- Pathophysiology
The person would be of the melancholic type of personality (see the four human temperaments: The factor 10 disease may be rationalized as a perturbed equilibrium of the body energy balance (see the four-element view of body components:


The clinical medicine logic

The physician works in a large frame of 3 pillars: the preventive medicine, the diagnostic medicine and the curative medicine. From a broad practical view the physician’s job is mainly in the curative medicine pillar.

The clinical (curative) medicine logics may be thought of as:
1- Adjunctive medicine
– analgesic, sedative, anxiolytic
– Mood modifiers
– Psychoactive agents
2- Casual medicine
– surgery
– invasive diagnostic and therapeutic interventions
3- Regular medicine
– nutrition
– common nonspecific agents: laxative, purgative, emollient, carminative
– specific medical agents
– antibiotics and antimicrobials
– anticancer agents


Drastic and devastating

Drastic and devastating

The title of this post presents two important words from the medical dictionary. “drastic” can be first seen in the homeostasis introduction to medical physiology course. It emphasizes the lack of adaptive and accommodative responses to sudden and strong changes in the environment. In such conditions the outcome can be quite damaging or even fatal. The word “devastating” can be found in the pathology essays such as those changes due to severe infections and it usually concerns a local pathological change, e.g. necrosis. Though the two words may originally concern natural events in the environment, they may provide clues to medical care and case evaluation.

In medical practice the care-giver should avoid harsh interventions in terms of course and dose. The treatment may be better doing when it is decent and incremental (opposite to drastic). That view in the medical care – in some situations – entails ‘partial correction’ of the concerned disorder as”rapid*” ‘full correction’ may bring about quite unwanted or even fatal hazard. It is always wise to have an overall vision of the medical case with top-to-bottom estimate so that such extreme flip-flops can be better appreciated and avoided. The treatment should be both problem- and patient-tailored. As the body’s reserves to accommodate changes (temperature, water, food, etc.) is limited and varying from time to time one should be careful not to be too rush or too slow.

By the way, the medical opposite of devastating can be ‘mild’ or ‘trivial’.

Take-home massage:

1- Be decent, systematic, and incremental.

2- Observe well.

3- Be open-minded, generous and evolution-ready.

4- Make your expectations as modest and small as you can.


* Suggested steps of management could be:

1- Reverse the current event.

2- Restore/establish base line.

3- Treat residual illness.



Orthotherapia (orthocura) – an interview –

orthotherapia (orthocura)

Interviewer: Hallo, everybody! Welcome to this episode of “medical views”. Today, we have another very exciting view of medical care, namely “orthotherapia or orthocura”. Let’s greet our guest; Mr. Physician 21, welcome back to our program!

Physician 21: Thank you. I am very happy to be with you today.

Interviewer: Would you explain the core concept of your orthotherapy?

Physician 21: Well. To start with, the idea is not by any means very novel but more it gathers and harmonizes some basic medical principles in a well structured and meaningful medical philosophy.

Interviewer: So, what are the main pillars of your idea?

Physician 21: Orthotherpia or orthocura claims that among all possible medical care regimens there could be only one that best suits a given medical case. While in this regard the conception of a presumed bodily functional hierarchy would be in the centre, some medical peculiarities are also much concerned including patient type, medical remedy type and mode of application.

Interviewer: Very fine Mr. Physician 21. Now, we are about to get that well structured and meaningful medical philosophy of orthotherapy. Would you bring us closer to those very interesting medical presumptions; first, what do you mean by bodily functional hierarchy?

Physician 21: The bodily functional hierarchy would mean that the various physiological functions and their body organs may be ordered in such hierarchical manner so that one function would be prioritized in respect to another. An example could be: lung > stomach > heart > liver and spleen > muscle and bone > gonad and kidney > brain. Such conception of possible hierarchically ordered body organs would help appreciate disease evolution from one side and disease management order from the other side.

Interviewer: How nice! We would perceive a glimpse of ‘alternative medicine’ in that presumption of bodily functional hierarchy, would you say that?

Physician 21: Well, I should say that I am not an expert in alternative medical methods. Anyhow, as I already said in the beginning the idea may not be very novel and it should make use of much of the well known medical arts.

Interviewer: Would you give practical examples to further explain that?

Physician 21: Well. Let’s consider a case of fever with signs of dehydration. The dehydration may be first corrected by giving appropriate fluids and then the body temperature could be assessed and managed accordingly. In such case, prioritizing fever to dehydration would be inappropriate and cost-ineffective. Another example could be the improvement of anxiety which reflects neurologic stress on practicing some suitable kind of sports. Again, in that case over consumption of anxiolytics may be cost-ineffective.

Interviewer: you mean that in handling diseases it makes great sense which disease or organ function to consider first to achieve a rather smooth and nature-coping healing process.

Physician 21: That is it. Thank you.

Interviewer: To summarize, “orthotherpy” or “orthocura” would emphasize the significance of choosing the management regimen with the presumption of natural hierarchical order of body functions and systems. Thank you very much. Mr. Physician 21 for this very interesting information.

Physician 21: Thank you too.


The clinical session algorithm

The clinical session algorithm

The excitement and challenge of the medical session are not to overlook especially for newly practicing physicians. Red cheeks, heart knocking, hand sweating and even head whirl may be typically experienced by many doctors even by quite experienced ones. The reason for such clinical session tension could be overestimation of the job and/ or lack of the successful scheme (algorithm) for medical management.

In this essay, I wish to emphasize that the tactful handling of medical care including clinical session is a matter of training and learning where the inherent talent influences the length of time necessary for such clinical mastering. About clinical session or examination questions regarding its duration, steps and order plus precautions and ethics are indeed worth noting. These together will shape out what is known as ‘the clinical sense’.

1- Context: what is the context of the clinical session?

By clinical session context I mean the time-place frame of the patient’s presentation. These circumstantial provisions may have influence on the clinical session as for professional progress and patient-doctor expectations. Besides care about medical perfection and contentedness the question whether a medical fee could or could not be considered can be quite sensible.

2-Patient type:  what kind of patient is this?

Broadly speaking patients may be seen as either chattering or serious. Because in some cases such definition and judgment of the patient may take time for the sake of fairness and respect to all patients, this question should be considered from the beginning and throughout the clinical session.

3- Presentation: what level of urgency does this case have?

The level of urgency may be graded in 4 levels: 1) life threatening problem, 2) potentially ailing problem, 3) naturally resolving problem and 4) intervention sparing problem.

In order to adequately define the level of urgency good knowledge and appreciation of the possible presentations (complaints) in the different diseases is required. For example, headache can be a symptom of different diseases like stress, constipation, muscle inflammation due to cold for example, fever, sinusitis, high blood pressure, etc. The level of urgency and, hence, appropriate management will vary for the same complaint from one disease to another.

4- Management plan: what to do for this case?

This question is answered at 3 levels: 1) immediate plan, 2) remote plan, and 3) Follow up plan.

The immediate plan is instituted for either therapeutic or prophylactic aspects. It can be omitted when there is no need for it or when the case cannot be yet well judged. Referral of the patient to a more experienced colleague and/ or medical care center is also possible option for immediate management plan. The remote plan may form a further management step or follow certain preparation with or without medications. The follow up plan can be needed for life long or relatively time lasting cases.

5- Clinical session closure:  what to do when you are done?

Considering the appropriate ethics, time and progress of the clinical session, the closure of the session should be smooth and well prepared ensuring that all the medical instructions and treatment plan given to the patient in writing and having the required and ‘allowable’ contact information taken by both physician and patient.