At the Doctor's Surgery

After a morning of thinking about stemmata, I was at the doctor's surgery in the afternoon, seeing a case where stemmata do not work at all. A German doctor takes notes as a series of abbreviations scrawled on index cards, which are actually envelopes to contain the various pieces on paper on a case. It is plain that computers have not made a breakthrough here yet, and it is obvious why. Anything that requires a doctor to start from the general and proceed to the specific, as most computer programs do, does not seem to appeal to the German clinician. A stemmatic approach would be to take perfect health as the root of medical reality and follow the lines in search of the ailment. It would take ages. What my doctor was jotting looked more like a series of "tags" about me: sick for three weeks, runny nose, allergies ... In the eyes of an experienced doctor, the tags clump together into a diagnosis. The medical mind works more like the Amazon search engine, where you enter a couple of words and the software seems to read your mind and suggest precisely the book you were looking for. Yes, the illness will have a code under the International Classification of Diseases (ICD) at the World Health Organization, which is a stemmatic scheme, but that seems a million miles from the practical world of clinical medicine.

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