Suspicious Minds?

Abstract

Although a range of professions may lay claim to performing diagnostic work, in the general public’s view diagnosis is predominantly a realm for the physician and the detective. It is also perhaps unfortunate that popular fiction and particularly popular television, generally display diagnostic work (and medical and detective diagnosis in particular) as the result of brilliant individual intuition, a moment of insightful cognition, a product of Poirot’s ‘little grey cells’. In this chapter, in contrast, we present and document diagnostic work as ‘everyday’ work, and work that routinely draws on a range of resources, necessitates a variety of everyday collaborations and a plethora of mundane skills. We outline the characteristics of diagnostic work as a form of skill and reasoning, mindful of Livingston’s comments that:

Three prejudices have surrounded studies of skill and reasoning. One is that reasoning is a mental process, something that takes place in the brain rather than being bound up with the material world and situated, embodied action. The second is that skill is a property possessed by individuals rather than belonging to a collectivity of practitioners. The third is that the nature and characteristics of skill and reasoning can be decided as matters of rational thought and disciplinary methods.

(Livingston, 2007: 199)

What makes a good diagnostician is the ability to maintain perspective despite maintaining a wide knowledge base. Sometimes, a cough is hereditary angioedema caused by C1 esterase inhibitor deficiency. Other times, a cough is just a cough.

(Deep, 2007)