How to Face Fear with Knowledge VI

Is It a Disease of “The Alzheimer’s Kind?”

Thoughts:

• The practice of medicine is a form of art. It is a practice of seeking a solution to the reason for the symptoms a person has by identifying its cause and treating both the symptoms and the cause.
•  
• Its method as executed by the practitioner of it includes his/her taking the entire history of the person suffering  including the part of the history which brought the person in seeking medical care.
•  
• The practitioner than enters after the history a list of all of the possible maladies the symptoms could be.
•  
• The practitioner then orders any tests qualified to reveal facts about the complaints bringing the person in seeking information not otherwise evident from symptom history or manifested on presentation or during examination. He/she also performs any tests for the different maladies appearing on the list of what the problem might be.
•  
• Initially as the tests are able to rule out any of the maladies they are removed from the malady list.
•  
• The practitioner then consults and takes note of all the medical knowledge available concerning the history and complaints and the test results along with the practitioner’s own knowledge and experience concerning the suspected maladies.
•  
• Once all of this is completed the practitioner will then go back to whatever is left on the malady list not otherwise eliminated and consider anything left as a likely candidate for cause.
•  
• From all of this the practitioner is then able to analyze all of it and form a conclusion defining the problem so it can be treated accordingly.
•  
• Based on the foregoing procedure the practitioner can also make a diagnosis by default using whatever is left on the list of maladies.
•  
• The key to a good diagnostician in the practice of medicine is having an analytical mind that can take in all of the facts and circumstances and make a reasoned decision about what they signify, if anything.
•  
• In more recent time the medical field has been inundated with scientific tests that purport to give exact measures in the results of what they test.
•  
• These aids have been most helpful for those using them as an assist. They are fatal to the practitioner who relies on them and nothing else in the symptom collage the patient presents.
•  
• The unfortunate turn of events that has accompanied this testing availability is too many practitioners and most of the public see the practice of medicine as a science. They expect of it the exactness the system of science often is. They cannot tolerate the ambiguity offered by the dubious practice of an art form which in fact medicine is.
•  
• They want answers. A “could be this or could be that”, or, “take this and call me in the morning” are not satisfactory.
•  
• As a result more practitioners rely on dials and dip sticks rather than their training and experience.
•  
• It is in this that the Diagnosis by Default often occurs. The malady list, after all other possibilities are ruled out, can be determinative of diagnosis. Under the rules of “Good Medical Practice” and within the definition of “Medical Certainty” whatever remains on the malady list of can diagnosed the cause of the symptom complained of.
•  
• No independent knowledge or fact need exist to qualify this as a reliable reason. The medical schools call this Differential Diagnosis. It is taught in the first year as the primary tool for diagnosis disease. If the formula if followed flawlessly the practice of medicine says what remains is IT!
•  

It is in this framework we have experienced the following:

• A 110 year effort to classify all dementia that can be called “of an Alzheimer’s Kind” into one illness. Each person diagnosed as stricken with it must have a similarity of symptoms to those the profession has predetermined to be the symptoms typical of one with Dementia “of the Alzheimer’s Kind.”
•  
• This reduces down to making a diagnosis of inclusion. It reduces the symptoms that might fit. It makes a surer diagnosis. It makes the class of the disease far more workable for the professionals.
•  
• This leaves the rest of the Dementias in the class of exclusion by default. It makes no determination as to what the symptom collage might be; it determines what it is not and leaves it swinging in the wind right there.
•  
• The purpose of all of this is to try and find the cause of the disease they have crowned with a name. The fewer different symptoms involved the more likely one mechanism can be discovered to be the cause and this be attacked with a magic pill if and when one is discovered.
•  
• This does nothing for the rest of the Dementias or the people suffering a similar disease that does not qualify as AD. Theirs is just as intrusive and damaging a disease. It produces the same limitations. It requires the same attention. It needs the same caretakers and support symptoms. It will affect families, communities and our country in all of the same ways.
•  
• Its only difference is it is not a disease of “The Alzheimer’s Kind” and therefore does not qualify for a name, support or and concern whatsoever. It doesn’t count!