Loss of intuition in healthcare

When your car begins to make an odd sound one day. And starts blinking its check-engine light. What do you do?

You check if your fuel cap is closed. If it still blinks, you take it to the mechanic.

The mechanic will tell you if there's a problem with your catalytic convertor, air flow sensor, O2 sensor or whatever. He'll replace or repair those parts.

Once the underlying systems are fixed, the check-engine light goes away. Because that's what it's meant to do.

You are then on your way.

At no point, do we imagine dismantling the bulb of the check engine light that's flashing. That would be odd.

But we don't pause while turning off check engine lights of our body

Our problem in healthcare is we expend our energy behind turning off symptoms. Making the pain go way. Not so much fixing the source of the symptoms.

Headache is a check-engine light.

Body ache is a check-engine light.

Fever is a check-engine light.

Ulcer or lesion is a check-engine light.

High blood pressure is a check-engine light.

Dare I say, a tumor itself could be a blaring check-engine light.

And what do we do?

We medicate to make the fever go away. We nip the lesion.

We go outside-in.

We don't like our body's signals because it's associated with pain and discomfort. It prohibits us from getting on with our lifestyles.

We try to make the signal (or symptom) go away. So that we can start driving again. As long as the body chugs along. Leaving the broken engine inside to mend itself (or not).

The patient with that painful lesion on the lip

I once shadowed a dermatologist in Kansas for many days. While we were building our EHR. He was a smart doctor. Caring. A lot of his day's work involved burning out lesions and using cryotherapy to freeze the area after.

There was this one patient (in his 50s) with one particularly painful looking lesion on his lip. Imagine a large sized mouth ulcer but on the front of the lower lip. Reddish brown outer, dull yellow inside. It screamed its presence every minute of the day for him. He couldn't take it any longer. And visited the doctor.

The doctor nipped it. Burned it. Froze it. Sent the sample for pathology to check for cancer.

The conversation tangentially touched on his smoking but not really.

Later that evening I asked the doctor. "Aren't we trying to solve the problem from the outside? Their problems seem deeper."

This is what he told me.

"Look, the skin is the largest organ of the body. They are coming to me for specific skin problems. They want that lesion to go away. Sometimes to simply feel better for themselves. If I don't remove that lesion, it'll drill a hole in the body. That's what they are coming to me for."

And we moved on.

The question to ask when our "check engine" light starts blinking

There's a question that'll help patients find their own answers. It'll also help doctors understand them more spatially (meaning, getting a more complete picture).

It may even sound kooky. And that's okay.

The question to ask is this: What's my body trying to tell me?

It's surprising what springs up when we ask that question. We may not receive answers we want to hear. Answers may seem totally unrelated to the problem at hand. In fact, we may get no answers at all. But the question is important.

Symptoms are body's way of asking us to listen. Suppressing them is like slapping a child who's come to you crying.

When we don't listen, the body expresses itself in even bigger terms. Until we listen. When the symptom manifests into a dominant disease condition. That's when we are forced to pay attention.

How do I know this

Well, after 21 years of popping a beta-blocker everyday, I overcame chronic hypertension. The tapering took 2.5 years under the guidance of different-thinking doctors. This year, I became drug-free. At a time when most of my generation is getting on some prescription or the other.

The experience gave me a grasp of how my body and mind function. Surely, data assisted. But it was intuition that directed.

When I look back, it's been quite simple actually. My body was telling me similar things all along. When I listened, there was no reason for the body to express in terms of higher blood pressure. After that point, I had to slowly reduce the reliance on the chemical combination that I had become accustomed to.

Our gift to listen from within

The dictionary defines intuition as the ability to understand something immediately, without the need for conscious reasoning.

When we over-rely on outside data for decision making, we slowly stop thinking independently. It actually goes beyond thinking. It's more to do with listening. To the message or voice that directs us intuitively. From inside of us. It's quite clear a voice.

For example, most of humanity is quickly losing its ability to drive or walk intuitively. We need Google Maps or something else. Many of us will say that's a good thing. That's what needs to happen with every industry. Including healthcare.

But it comes at a cost. Of muting a sense.

I was on a trek earlier this year in Peru. We were deep within the Andean mountains. Someone asked, what's the difference between fruits and vegetables? And why exactly is tomato a fruit?

No one knew.

(Wasn't it Feyman who talked about the pleasure of finding things out? Yeah, we are quickly losing that.)

Then we had the expected urge, as soon as we have connectivity, let's Google and find out.

Amen.