"When a Cause Cannot Be Found", 2020, Anjum & Rocca

A lot of this is about medically unexplained symptoms. I haven't read it and don't think I will but perhaps there's somebody, perhaps from a philosophical background, who might find it of interest.

https://link.springer.com/chapter/10.1007/978-3-030-41239-5_4

Rethinking Causality, Complexity and Evidence for the Unique Patient pp 55-74| Cite as

 

Not exactly bad, though I only skimmed, but it's a lot of unnecessarily fancy words for something that always has the same answer: you just keep working at it and if your tools and methods still don't solve it then you develop new tools and methods. The current approach is to constantly do the same things in a loop with minimal budget, no overarching strategy and little oversight, no wonder it doesn't pan out.

This approach literally works 100% of the time. In all fields of science, not just medicine. There are some lessons from hindsight to consider here. See: the germ theory of disease and the ultraviolet catastrophe. Something being impossible is usually a good sign to take several steps back over who decided that something was impossible and why.

Good to notice the problem of the ideal patient, however itself a myth that needs to be dismantled. See: heart attacks in women. Also: literally all immune and autoimmune conditions. Nature is messy and chaotic, insisting on beauty and elegance serves no one. If you want perfect machines with predictable behavior become an engineer, where people skills actually are optional.

 

If that is the proposal it is rubbish. We identify cause by finding a consistent relation across many examples. We have no other means. Whether you call this Humean or not is irrelevant. You can never identify cause in a single case.

I suspect this is all about finding cause in the 'patient's narrative and perspective' - i.e. the standard psychotherapist's approach of making things up as you go along.

 

As an engineer who spent a lot of time on customer site I dispute this. Early on i wasn't really interested in the people & that machinery is so much more straightforward. I remember the day someone came to me reporting a fault that simply wasn't possible. I arrogantly told them so (I was young & inexperienced - still no excuse). They were annoyed and I told them when the exact same thing happened again call me immediately. They did & I went and investigated. They were right, the impossible was happening. I spoke to all the manufacturers involved and got my own initial arrogance reflected back. I did resolve it - it was a complex problem not seen before that only happened under specific circumstances with a particular third party piece of kit installed.

I apologised to my client and learned that I really didn't like making myself look like a complete a***.

I have seen supposedly identical systems operate differently.

As an engineer whose main focus is to get machines working the way the client needs and expects I have learned that knowledge is all very well but only gets you so far, being curious, interested and prepared to invest some energy investigating get you a lot further.

One of the most important lessons - listen & interact with my client. It helps no one if I install, configure or fix a system or process that doesn't do what it's needed to. I can only do that by listening to my client, understanding their needs & issues, making sure they are aware of all implications of what we've agreed to do. Then, at set milestones or when the work is complete, confirming with them that we have achieved what we set out to.

If my design or fix isn't successful by my client's definition, as discussed & agreed up front, then it isn't successful. No wiggle room, no redefinition. This is how the real world works.

If an engineer, whose focus and training is machinery, understands that communication is fundamental to everything they do & that, however much you know there is always more to learn, then I fail to see why people who consider themselves experts in people cannot.

 

Self-causation?