in-the-point (poems and essays)

The foul entity – an interview –

Interviewer: Hallo, everybody! Welcome to this episode of “medical views”. We have today an interesting topic that should deserve our attention. Let’s welcome our guest. Welcome back, Mr. Physician21, to our program.

Physician21: Thank you very much for this nice introduction. It is my pleasure to be here.

Interviewer: I think the topic of today have special importance as its name implies, ‘the foul entity’. How could you imagine it?

Physician 21: ‘The foul entity’ as I could imagine is a natural component of our world that can turn our life to a true hell. We people do not like to have problems but our life does need them, anyhow.

Interviewer: So, ‘the foul entity’ is the site or station where all devil would be knitted.

Physician21: Yes. That’s it.

Interviewer: You mean it implicitly that the problems we have in our lives would have similar patterns that can be foreseen in definite paths and models.

Physician21: You are right.

Interviewer: So, what is the significance of your view in attributing the entire devil to one thing, one station or one entity?

Physician21: The advantage is quadruple. First, you won’t handle people in some unpleasant situation but you consider a divinely present ‘foul entity’ that knit problems – by dimension – for our satisfaction. Second, here, people are only objectified in the course of ‘the foul entity’. Then, you ultimately do not condemn people who may or may not resolve any time. Third, according to that view problems – both from outside and from inside one’s self – can be better foreseen, received, interpreted and handled. Fourth, the existence of a ‘foul entity’ should lead to the belief in a much larger good ‘all’ that contains and maintains all good meanings and things. Of course, the attachment and belonging to such great good all would bring a great joy and relief every time one is aware of and protected from the bad effects of ‘the foul entity’.

Interviewer: This imagination sounds very beautiful when people do not condemn one another but only condemn the bad deeds and be aware of their divine source according to your view. How could ‘the foul entity’ affect someone in a bad way? And where would be the protection sought for?

Physician21: ‘The foul entity’ may work in different ways or models, for example, through the “bad chance” like when somebody calls you by mistake at midnight. In this case you should know it was not meant to bother you. The protection shields against the foul entity include, therefore, positive thinking, forgiveness, generosity, innocence, reflection, and good spirituality.

Interviewer: To summarize, ‘the foul entity’ as imagined by our guest is a natural component of our moral world that is needed to refine people’s ability and willingness to do well. So, it ultimately works for our benefit on the condition that we are able to divert its seemingly bad tricks and plots to the flourishing of our really good. Thank you very much, Mr. Physician 21, for this great idea.

Physician21: Thank you, Sir, for your extraordinary presentation.

in-the-point (poems and essays)

The foul entity

All the cares and problems I had seem to come from one “thing”, one “structure”, one “entity”; let it be the foul entity. This is because the problems and the embarrassments would happen in a similar pattern: misunderstanding, different views, variation, misfortune and harmful chance. But what if our whole life is based on naughty working of such “bad entity”? Would this also be a bitter makeup of our world?

The world seems to me to be basically nicely sounding, happy, enchanting and fruitful. Let it be the skies, they look wonderful. The nature in Earth is also beautiful with peaceful plants and innocent animals. The good is by far much greater than the bad; the good all is much greater than the small foul entity. But apparently we people would not be likely to survive or to advance only in that vast good all and the existence of such small foul entity would be, therefore, necessary. We have to taste bitterness, feel pains and strive for values and good answers and responses.

When I do well I become more attached to the good all and more apart from the foul entity. The reverse is also true. Here, I no longer have problems with people who would do bad because they become merely a phenomenon of the working of a divine foul entity that would harm only susceptible people who are somehow not protected from its harmful effects. Those harms are all undesirable things we may have in this life like disease, cares, shortage of resources and disability.

There are definite and finite protection rules for happiness and satisfaction against the automatic working of the foul entity. These include forgiveness, innocence, generosity, hope and prayers for one’s and everybody’s health and wealth.

At this time I feel how great I would be, how important and how valued. As the good all would be on my side when I do well and good. I am not in charge to change badly doing somebody or some bad circumstances but I am ready to understand that it is all about help and hope to evade a continuously working foul entity for the sake of people’s benefit and advancement.


Disease characterization and classification


disease characterization

In the medical field, a disease may be regarded as any objectively addressable deviation from the abstract normal. That abstract normal would be assigned a “neutrum” of customarily and/ or scholarly defined state of equilibrium and perfection.

Very remarkable is that the human normal is not shaped, as may be noticed in the phrase above, only by physicians or medical professionals, but also by thinkers, philosophers, scientists, creative minds and the general lay people.

In order for such “disease” to be defined or characterized a few parameters should be fulfilled.

  1. Type of the person in whom this disease may be seen.
  2. Onset of the disease.
  3. Course of the disease.
  4. Associates of the disease.
  5. Common outcome of the disease.
  6. Name of the disease.

These are 6 parameters that would be quite sufficient to characterize a disease on gross and perceivable measures by scholars and the lay as well. The knowledge about the cause(s) and underlying micro changes and molecular mechanisms fall to the interest of a few people including the health care providers.

Let’s talk briefly about each of these disease parameters in hand of common examples.

Type of patient includes:

– Age (child, adolescent, adult, and elderly),

–  Sex (male and female),

– Stature (stunted, average, above average)

– Body shape (slim, average, obese),

– Race (Caucasian, Negroid, Mongolian),

– Personality (easy, strict),

– Acquaintance (poor, average, high).

The relevance of patient’s type to the disease is understood by the fact that some diseases are more common in some patient’s types than in other types.

Onset of the disease

This means how the disease was noticed by the patient or the relatives.

– Sudden onset: the disease has commenced very acutely. Example: a thrombus formation in the leg (deep venous thrombosis, DVT).

– Gradual onset: the disease commence over relatively long time. Example: weakness in the leg due to a disc hernia.

Course of the disease

This describes whether the disease tends to increase, decrease or fluctuate as time passes (over relatively long time) without any interference from the patient’s side.

– Progressive course: e.g. progressive decrease in visual acuity.

– Regressive: e.g. so-called self-limiting disease that resolves gradually by itself such as common cold or flu.

– Intermittent course: this describes a disease that tends to appear from time to time.

Associates of the disease

These imply the relation of the disease to other things like food, drinking, activity, stress, posture, etc. Among the associates of the disease we can consider risk factor(s), e.g. obesity is a risk factor for type 2 diabetes mellitus, and precipitating factor(s), e.g. water restriction is a precipitating factor for renal troubles.

Common outcome of the disease

This is how the disease would most probably set its end.

– Self-limiting, self-curable: usually no treatment is needed.

– Ailing and incapacitating: treatment is needed.

– Life threatening or fatal: treatment is needed.

Name of the disease

This is important because it helps in reliably and efficiently preserving and communicating knowledge about disease.

The terms: “natural history of the disease” and “the full blown picture of the disease”, are helpful in presenting the disease as well characterized entity with its unique components and behavior.

In the realm of disease a classification system may be very necessary in order for easy sorting and recall to be in hand. It is anyhow not an easy job to classify diseases at any known or unknown factor, e.g. their causes. As medical practitioners and students we used to have medical terms such as:

– Infectious diseases and noninfectious diseases

– Organic and psychological diseases

– Genetic and acquired diseases

In addition to other terms like trauma, congenital, psychosomatic and constitutional.

From a practical and treatment-wise approach, I would classify diseases into two main classes: biologic and nonbiologic. In the former class some living organism, e.g. a bacterium, a virus, a parasite such as E. histolytica or a worm, is almost certainly accused for making the disease. In such a case the effects of such biologic invasion must be well assessed and specific treatment may be given as appropriate. Such a microbe- or parasite-oriented treatment may be in some cases life saving as the timely diagnosis and treatment are crucial for favorable outcome. For the latter class of diseases, in which such accusation of an invading organism is quite unlikely to bring about the disease, the treatment will be chiefly concerned with combating the illness through general and/ or specific treatments.

Now,     I wish to present a master for patient’s diagnosis that would be comprehensive and elegant as well:

* Moderate jaundice in otherwise apparently normal 3 days female neonate of type 2 diabetic mother for general treatment and investigation.

* Renal colic in other wise apparently normal 6 years boy for general treatment and investigation.

* Moderate fever (38⁰C) in reportedly hypertensive obese; easy taker 49 male adult for specific antibiotic treatment and advisable investigation.

* Slight Albuminuria (+) in otherwise apparently normal; tense taker 19 weeks primigravida, 32 female adult for mandatory weekly-monthly follow up.

This 5-site patient’s diagnosis comprised: 1) patient’s most relevant complaint or finding, 2) patient’s look and/or medical history, 3) patient’s type, 4) suggested treatment, and 5) investigation.

With the expected advancement of disease characterization more molecular designations will be available for common use that would reflect an increasing awareness of molecularly-oriented medicine.


Cherchez la stagnation

cherchez la stagnation
Stagnation is a non-medical word that may form a basis for a myriad of medical problems. The human health is dependent on a balance between seemingly opposite processes like wear and tear, and production and disposal. Stagnation in this medical context may manifest clinically as bodily and/or psychic illness such as abdominal pain and headache or anxiety and fears, respectively. Here are examples of medically relevant stagnations: emotional, creational, moral, social, physical, sexual, and instant.

Emotionally stagnant person is one who can’t express his/her feeling and thoughts. Creation includes free thinking, learning and bringing ideas into light. Morally stagnant persons are those who insist to do good while they miss support or encouragement from other people. Social prosperity is a matter of acceptance, tolerance, equality and fairness. A body that moves either by doing manual work or sports is likely to be physically cheered. Sexual stagnation may occur due to lack of regular and satisfactory relationship. By instant stagnation I mean a physical disease like biliary or urinary obstruction.

A good physician should consider the pivotal role of “stagnation” in health derangement and learn about the means of its detection and repair.


Disease time plan

Our cumulative knowledge about diseases shows that they occur according to a definite time scheme that may provide clues for their approaches and requisites. A certain disease known to affect an adult person may be inapplicable to mention for a child, for example. This is why noting the age of a patient is relevant to the possible diseases thought of (so-called differential diagnosis). For example, G6PD deficiency is a disease due to deficiency of a protein enzyme needed for replenishment of important detoxifying compound in the body, reduced glutathione. The disease is usually evident in young children when suffering an infection or on taking certain chemical drugs. Schizophrenia, on the other hand, is a mental disease with an onset typically in young adulthood. In this viewpoint, the life stages of a human; newborn, child, adolescent, adult and elderly, should fit for possible disease events besides their relevance to specific physical, mental and emotional characteristics.

Diseases may be classified according to their causes as follows:

1- Nutritional: caused by short of supply of food and other nutrients, e.g. vitamin deficiency.

2- Genetic: caused by certain gene defect or variation, e.g. sickle cell anemia.

3- Infectious: caused by certain pathogen as viruses, bacteria and fungi.

4- Multi-factorial: caused by different convergent mechanisms,  e.g. diabetes mellitus and hypertension.

5- Traumatic: physical and chemical insults can cause inflammatory body reactions.

Foot-note: a disease may be regarded as an age- and constitution-reasoned extraordinary experience or complaint about some physical, mental or emotional state of an individual that maybe stated either by the affected person or by some people in his/her vicinity or by both.

in-the-point (poems and essays)

Health is not more blessed than disease

Wishing good health is a constant thought that grows with us spontaneously. A healthy man is expected to have a happy long life. On the contrary, disease is quite frightening to most of us and usually arouses bad expectations and pessimism. Although this point of view may be generally accepted, there would be much debate about what health and disease would mean. The question if health is always a bless or if disease is misfortune, shows another aspect how these two can be weighed.

In fact, health owes disease a lot. Apart from giving contrast and rationale to understand health, a disease may advance or promote health, e.g. by conferring immunity. Health and disease should, thus, be seen as proponents rather than opponents. On the moral and spiritual level, a disease is as praiseworthy as health for finer perception and attitude.