The Study of Cases

The study of cases is the study of life as cases are stories of life evident that unfold with attention to the significance of process. These essentials of life, their continuation and the perversions of these processes that lead to disease and dysfunction are uncovered through this process of examination and consideration. From the beginning of inquiry through the diagnostic logic, the clinician unweaves a tale that unfolds the subtle signs of the quality of live evident. This inquiry and consideration are the search for the known and reliable and are the foundations of successful diagnosis and treatment. And it is the exploration and documentation of this process that is case study. Information gathered on this tapestry of organic process informs constructive logic within systematic examination and evaluation. This leads to a working diagnosis and to treatment principles and methods. All is followed by conclusions and an assessment of results.

This class is the study of how to study a clinical case and the process of signification; the understanding of energetic autopoiesis or the ability of an organism to self-organize and function in such a manner as to intend the integrity of wholesome health and its continuation. Without an understanding of life’s organic paradigm, process has no norm and conclusions can breach the common sense and thus invite dysfunction and disease.

A case study is a puzzle to be unwound by the reader, the filaments and hints of information, signs and symptoms untangled within the inherent view of both Chinese medical logic and, in this class, modern biomedical logic. The object of the writer is to weave a tale that places the reader in a similar position as the writer with all the attendant information and descriptions that allow one to follow the inquiry from the same position as the writer. This is the problem solving of the clinician in writing; the process of discovering what they know. It is here that information gathered leads to conclusion and not the conclusion that leads to the gathering of information, as this is what separates mere opinion from a well-wrought conclusion. And it is here that through this development of tacit understanding that one engages in heuristic learning.

The writing of a case study involves contributions from both clinical inquiry and scholarly research. In short, it is perhaps a demanding academic study, as each case study begins with the attempt to alter or adjust the course of organic process with studied skills and apply reference and research to build and substantiate the engagement. The result is tested in real time in the clinic with a report on conclusions of patient progress and an assessment and reflection of results. It is the process of the constructive logic of problem solving in ink.

And the challenge for the clinician is that this constructive thought process must produce results. The results of pure scholarly speculation do not resonate with the clinician who is entrusted with the sober outcome of clinical results, as the clinician is the individual that stands face to face with the destiny of another to alleviate suffering. Without such consequential results, speculations about cause and effect suffer fatigued creativity and have no place in clinical medicine.

The scholar is known as specialist in a field of study. Case study requires knowledge above and beyond the careful and immediate and perhaps intuitive response of the clinician. It requires research. The literate history of Chinese medicine spans millennia and it is entrusted to the modern scholars of Chinese medicine to avail themselves of this deep treasury of knowledge. Principles and agreements that have been worked out over and over through peer review are the bones of what is today the practice of this medicine. Thoughts and process that have been observed and documented through the clinician’s eyes and recorded and analyzed by the scholars form the literature that informs the training of the modern physician of Chinese medicine. Terms and concepts long studied are brought forth to evaluate the vitality and perversion of organic process. These deep commitments, first to wholesome and functional integrity, then to the honesty of vital organic process, form the basis of consideration for any clinician of this medicine. It is on this solid and reliable study of organic flux that the scholar weighs the considerations of present observations with that of the written contributions of his predecessors.

It is through this process that the student demonstrates the skillful and compassionate response to suffering that is the tapestry of any clinical intervention. This is the scholar clinician; the best example of what Chinese medicine has to offer in its centuries old engagement of human destiny.