Differntial Diagnosis

[katah]

So, what forms of diagnosis do we all think would be available to our favorite healers in Pern?

On a similiar note, someone mentioned that the dolphins are in this story line and if that is so then are they used for their sometime gift in diagnosis and if not, why not?

I have that we use microscopes of some time. What else?

[katah]

Along this note, do we have stethescopes of some fashion? Do we use gloves? What are the gloves made of?

[Chantal]

We have crude stethoscopes--because one can be built with a hollow tube. I don't think we have gloves, but we do have redwort that healers dip their hands in to cleanse them. They might have cotton gloves, but certainly nothing like latex.

I think they use their senses to make diagnoses--sight and smell, particularly, palpation, auscultation, probably also familiarity with their patients to the point where they can 'feel' when something is wrong. I think they look for physical signs--drooping, one-sided expression, I think they do the basic observational things before doing blood tests. They probably collect urine, though. It used to be said that a good medieval physician could tell a lot about a person's health just by looking at the urine.

[Hope]

Stethescopes were largely invented so that doctors wouldn't have to stick their ear up against someone's chest. The ear to chest method actually works pretty well, although I doubt it would work to hear a fetal heart beat, which can sometimes be heard by a good modern stethescope after about 24 weeks. (Still, I've never tried it, and expect if I did, I'd get kicked in the ear for my efforts.)

Microscopes could detect abnormal cells in urine--blood or microscopic pus, and maybe identify bacteria in cultures. But I agree that the vast majority of information would come from listening to the patient, looking at the patient, and touching the patient. (Occassionally smell, too--I can identify strep up close, and a GI bleed from across an ER department. And gangrene, but by the time you smell that...well, it's bad. Definitely time to amputate.)

There is also a healer sense that is a subliminal combination of the others that allows you to look at a patient, or touch them, and know that Death is waiting. This can be frustrating when a patient is doing OK on paper, and you know he's not, but you can't explain why....

Is this sort of thing helpful to people? I often don't know what to share, what will be most useful for people writing.

[Anna]

As for the question regarding dolphins: well, it's never come up before. There's no reason wy that ability couldn't be 'discovered' at some point.

[Chantal]

My thing about the dolphins is, how do you diagnose, that way? Do you keep the dolphins in a pool by the infirmary? Do you take the patient out into the ocean? How do the dolphins communicate? Just to their dolphineers?

I can imagine Aerden not yet being a convert, having grown up around Benden, where it's cold, and you get little exposure to dolphins. His attitude: "But...It's a fish. How is it supposed to diagnose anything?"

Which brings up another question--How presicely-phrased would a dolphin diagnosis be? "The patient has amyotrophic lateral sclerosis" or "His muscles are dying."? I haven't read the relevant book and don't know which one it is, so this is all new to me.

[Hope]

It's unrealistic (OK, maybe that word just doesn't belong in this post) to expect dolphins to interpret human anatomy or health. They are a sonogram translated by someone with no health background who knows your speech only as a second language. So...you could find out a woman was carrying twins, or that there was a large fluid filled collection in someone's abdomen, or that there were big holes in this organ over here (why would they know the word for liver?) A dolphin could learn the names of human anatomy, but I don't think they could learn enough physiology and pathology to be diagnosticians. I'd find the usefulness limited, because--how much can we do about what we find?

Dissenting opinions welcome!

[Chantal]

Hope--I found your discussion of a doctor's subliminal senses to be very informative and helpful--and reassuring, if you have a doctor who listens to that sense.

I would be interested to see what sorts of things a dolphin could point out that a human healer might miss. Spotting twins is actually an interesting idea. But yeah, you'd have to have a medically-trained dolphineer and anatomist who was very skilled at interpreting the information gained from the dolphin. And yeah, there is the issue that invasive treatments would be limited.

Though I begin to wonder if the prevailing attitude of limiting the performance of invasive surgery is not in itself a barrier to the increase of knowledge and the invention of techniques to overcome the low tech level. Even ancient Egyptians and Romans did procedures like cataract removal and trephination, and their technology was, if anything, lower than the Pernese have. Is there no possibility that someone might invent chloroform or ether?

I'd think the Pernese would be no less adventurous than we were, in this area. What's holding them back, ironically, is their advanced knowledge.

[Anna]

Have either of you read Dolphins of Pern? It's been a while since I have, but I think but it may answer some questions about how dolphins would know.

Of course, it would take very specialized training for both the dolphin, and the dolphineer. But dolphins had metasynth enhancements which were extremely successful, so they're supposed to have human-level intelligence.

I THINK. I'll reread Dragonsdawn and Dolphins this week and see if I'm remembering right.

[Chantal]

I haven't read Dolphins. The amount of fiction I've been reading lately is very, very small; mainly I'm more interested in non-fiction, now. Why that is, since I want to be a writer, I don't know.

[katah]

I only vaguely remember Dolphins. It wasn't my favorite book and I was a skeptic of the Dolphins...and my impression in the book was that the use (if I remember correctly) was limited and might have even been somewhat new in the book? Does anyone remember? I think it would be limited.

[Chantal]

I'd think it would have to be limited, too. You'd have to train the dolphins and dolphineers so very much, to get useful diagnosticians.

Though, hey, a dlophin with an attitude like House's could be amusing.

*runs away fast*

[Hope]

I think that ether, or the equivalent, is possible, and even likely on Pern. What we have to remember is this:

Anesthesiologists don't get paid the big bucks for putting patients to sleep. They earn them by waking the patients up again.

There was a great episode on MASH, many, many years ago, when they ran out of modern anesthesia and had to use ether. In addition to some poor outcomes, they had doctors and nurses keeling over from the exposure.

Remember...the more you value human life, the less you are willing to experiment except in extremis. I think that that may play a part in keeping Pern from advancement. (That and the periodic loss of knowledge.)

[Chantal]

Hope--Yes, exactly! That's what I was trying to say, though it didn't come out clearly. They KNOW what can go wrong, so they don't like to be as risky.

I was given ether when they took my tonsils out. Nasty-smelling stuff.