The Mind of Medicine: The Beauty of Diagnosis : Emergency Medicine News

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Emergency Medicine News

The Mind of Medicine

The Beauty of Diagnosis

Kumar, Anoop MD

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Emergency Medicine News 43(11A):10.1097/01.EEM.0000800224.01028.20, November 10, 2021. | DOI: 10.1097/01.EEM.0000800224.01028.20

    Gnosis, or simply knowledge and knowing, is often associated with ancient wisdom traditions. But we are all seeking gnosis through the activities we do.

    The drive behind doing science, for example, is the effort to know the world around us and know ourselves. A scientist may work alone in a laboratory, but a physician necessarily works in relationship with a patient, partaking in dia-gnosis, knowing that flows between the shores of two individuals. It is a shared knowing, and therein lives its beauty.

    We walk into patients' rooms, introduce ourselves, and invite them to tell us their story, asking them to translate and share their gnosis. They are the experts when it comes to their experience. We are the experts when it comes to having a framework for understanding those experiences, given a set of assumptions. These two kinds of gnosis meet in that tender space between the physician and patient. This is why the doctor-patient relationship is sacred; it represents a shared gnosis, a shared living, a shared being. The expertise of one is not enough.

    The best diagnosis cannot be reached when gnosis is not shared. We move from the range of diagnosis to the range of monognosis, a one-sided story. Abdominal pain may be a good diagnosis, but a better diagnosis may be appendicitis, provided it is suggested by the history and exam. In this space between the doctor and the patient, waves of knowing ebb and flow, revealing to each, wave by wave, the shared diagnosis. Laboratory testing and imaging contribute to this picture to the extent the picture has been fleshed out through the experience of sharing.

    Next time you walk into a room, pause to recognize the tradition of shared gnosis in which you are partaking. It is a tradition as old as humankind.

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