I
I depend on the cool heartless medical intuitive part of my brain. It speaks to me. It does not have much emotional content besides dry humor and irony.
II
This part of my brain gathers evidence. It is endlessly curious, rather like the Elephant's Child's insatiable curiosity. It gathers information and plays with the pieces, like a puzzle. A pattern will form, quite suddenly. I will write orders, based on the pattern, before the pattern even really becomes conscious. In other words, sometimes I write medical orders without being able to explain the evidence. My left conscious logical brain is often not really aware that the right intuitive brain has taken over. The left brain will later try to figure out what the evidence was. The pattern is visible by then, usually, but the right brain puts it together in my unconscious and then acts on it. It feels as if the landscape has quite suddenly been altered, like being teleported, and it takes a while for the left brain to realize what has happened.
III
The first three times that I really noticed were all in obstetrics. Twice I had patients who had had cesarean sections before. We were trying to do a VBAC, Vaginal Birth After Cesearean. The fetal monitor strip was making me twitchy. I called the obstetrician. He came to the first one. He looked at the hallway monitor. "Well, the strip was a bit yucky back here, but it's better now. Are you sure you want me to consult?" "Well, she's a VBAC and I just have a feeling, yeah, go introduce yourself." He went in the room. The baby's heartbeat dropped to half and stayed. We did a c-section. The second time was similar. The third time the fetal strip was not bad and yet it was. I called the obstetrician. It was the woman in the group. She studied the strip carefully. "Ok." She said, "I don't like it either. There isn't anything that I can put my finger on." We went to talk to the patient. We essentially said, "We don't know why but we want to do a cesearean section now." The pregnant mom must have felt it too, because her reply was, "Do it now." What we found was the umbilical cord wrapped four times around the baby's neck and slightly stretched. I don't know about the obstetrician, but that sort of finding makes me break in to a reactive sweat. We felt really good, all of us, about pursuing the cesarean section. And I don't ignore little niggly feelings in the back of my head.
IV
I'm not the only doctor who operates in this mode at times. I worked with a rural physician. One morning he said, "God must have been watching out for me Friday." "Why?" I said. He said, "I saw a 14 month old on Friday. Fever and cold symptoms, didn't look any different from usual. But for some reason I got a blood culture. Came back Neisseria meningitidis." N. Meningitis can cause meningitis and sepsis, where the blood pressure suddenly drops and it is often lethal. That child was septic but looked fine. He started the antibiotics and it remained fine. "I guess God told me to do the culture."
V
I am tickled by the idea of that voice as God. If it is, I hear God as female with a dry sarcastic sense of humor. And pitiless with opinions, presented as evidence based on facts.
VI
I don't think of it as God's voice, so don't call out the white coats. But it feels big and deep. I think of it as the unconscious, or a connection to it. There is always a lot going on around us that we don't notice consciously. Even though I said that it is heartless, it isn't really. It feels connected, very deeply. When I was in counseling, during divorce, I dreamed of the ocean and water, over and over. To Jung, water represented the unconscious. The water was safe. It also was deep and untouched beneath the surface. I had the feeling that the divorce was a storm on the surface, a big horrible storm to be sure, but that the depths were not touched. I also like Jung's idea of the greater unconscious and wonder if some of the information that I "pick up" is via that route. I told it to shut up in another writeup. But I don't mean it. I ask it questions all the time.
VII
The unconscious is a mysterious place. The book "Small Changes" talks about asking your office mate what color car they parked by that morning. They probably can't tell you. But ask them three days running and they will know, want to or not. The unconscious shifts its' attention and now that information is available to the conscious mind. The information may have been noted the first two days you asked, but not deemed important enough for consciousness, since there is always too much information. The brain has to filter it.
VIII
Not only is it deeply connected, but it is oddly comforting, for something that I initially described as "heartless". That part of my brain is not afraid of grief, of fear, of emotions. It is rather okay with all of them. As if they were waves and weather on the surface, something that comes and goes. And that is what emotions do, after all.
IX
When I was a very small child, circumstances combined with my nature. I decided that adults were untrustworthy liars and were unreliable. They were undependable. It was not unreasonable in view of the circumstances. I watched adults very carefully to see if they would do what they said. I noted whether their spoken ideals matched their actions. My son was an exchange student to Thailand and he was outraged to find that many adults are hypocrites. I said that I think really everyone is, at least to some degree. He was being punished for breaking the very laws that his hosts were continuing to break. He was outraged that I'm not surprised.
X
During the divorce, I told my counselor that I was realizing that not everyone wanted to be "read". That I responded to the physical signals and way people acted as much as I responded to what they said. This has earned me the reputation of being an "amazing diagnostician" but gets me in trouble in social situations. I said that I didn't know how to turn it off, but was trying to learn to ignore the cues in social situations, rather than name them. My counselor nearly giggled and said she'd had to learn that too. And my sister says that at parties she has a running dialog with herself. "Hmmm, that person is acting like someone from a drug or alcohol household. Hmmm, why is he depressed? Gosh, look at the vibes on this one!" I don't see it as an aura. More like the elephant in the living room. I was floored to suddenly realize that there are people who really do not see the elephant. I find it damn hard to ignore. I hope to learn acceptable party behavior by the time I'm 90 and then I'll enjoy ignoring it.
started in 2010 or thereabouts