Circles

I am sort of thinking about the critical components one needs to assess the medical apparatus and have introduced a couple of concepts, such as semiotics and the notion of complexity, as in non-linear.  

Recapping, semiotics is a way to understand communication, from bacteria to humans and anything else with a formal system.  What is important here is that the folks who are acting within a system, like medicine can sign (communicate) without express understanding of the system itself.  That’s what anthropologists are for.  Or at least my breed.  There are a whole raft of anthropologists who have adopted western medicine as a truth and try to figure out how to apply the best of that to other cultures.  Think about AIDS prevention in Africa. But we few more critical types are interested in the very nature of that medical culture.

And complexity?  Well, interesting you should ask.  Most of what we take for granted about medicine was decided way before we really had any notion of how biology might work.  The body was a machine and medicine was about repair.  Of course, that is all wrong, but lots of notions about the body as a machine persist in both popular culture (whatever that means) and in medicine.  So being schooled in understanding the inherent non-linear nature of biology makes it easier to understand why folks in medicine don’t understand it (mostly, it is not useful, relative to the stories medicine tells about people).

So the last leg on the stool (I hear this from business types all the time, when constructing a pitch for funding.  Need at least ‘three legs on a stool,”  meaning your pitch has to have three compelling components) is rhythm.  Huh?  Yeah, rhythm.  Turns out that not only is biology strictly complex, it is always rhythmic.  Why?  Well, to communicate information in a biochemical system, one great way is using ‘difference.’

So the relative ‘amount’ of a biochemical is information.  Turns out that all of our biochemical (and all other behaviors) are rhythmic, meaning that there are normal and necessary oscillations in all of our basic biological activities.

Medicine knows this to be true, but the very way that data is collected and reported, say in clinical trials, assumes this to be untrue.  Take something like body temperature.  It follows, in healthy folks, a 24-hour cycle (called a circadian rhythm).   



 

But what many, many studies will report, is an average temperature for a human, without noting the time of day.  Virtually all studies commit the same profound mistake, as if it didn’t matter.  Here is the analogy.  If someone asked you to tell that what the average time of day is, you’d likely look at them as if they were nuts, since the time is cyclic and therefore a term like “average” isn’t really meaningful.  Or what if someone asked you the average temperature where you lived.  Would you give them the annual average temperature (say 61 Degrees F in Omaha, NE or 76 in Cairo).  Not very useful if you want to know what to wear.  You might ask what time of year, day or night, etc.  Well, our biology, like all biology, is identical.  Variations daily, weekly, monthly, and at least yearly.  But the ‘average’ hides all of that.  Most folks in medicine I talk with don’t even know this is true, but certainly are not interested.  Almost everyone.

So the stool has three legs. Semiotics, complexity and rhythm.  I’ll go on about each as time goes on and will give lots of examples from the business of medicine. because it determines what kind of medical care we have, from the disease itself to the treatments.