[5.3.4]

Part 2

Thus, the official model and practice of medical assessment fails to meet, on a day to day basis, the scientific, pragmatic, and ethical criteria of acceptability to the community. Even its experimental tests are suspect. The weaknesses here are clear from numerous reversals the FDA is required to make, recalling products it had previously approved --to an extent now remindful of the car industry products. Since the medical assessme;t model is unsuitable and unattained in the day-to-day practice of the physician, there is need for a more practical routine. This pragmatic problem involves, to an equal extent, the assessment of all medical issues, including the health and nutrition issues raised by the natural food movement and the spiritual healing practitioners, both religious and non-religious, as reviewed above. To solve this problem, the talents and techniques of applied social psychology are needed. It is clear to us, that nothing less than daily round approach can offer a methodology sufficiently situational and actual, to operationalize the medical assessment schema,

which now remains theoretical and experimentalistic, and dependent on extrapolations of dubious validity and safety. Similarly, if the counter-medical ideology is to gain scientific status, rigor, and dependability, then it too must look for a better justified basis of evidence, a more systematic and unified approach to anecdotes, testimonies, and case histories. We propose to elaborate concrete methodological procedures for the gathering of normative daily round data on matters of health and functioning. These procedures are applicable to healthy and treated individuals so that they provide not only normative data, but as well, allow the objectified assessment of changes over time, and hence, are suitable for the clinical assessment of treatments and identifiable exposures. Accordingly, we need to evolve through empirical means, an implementation paradigm for the basic medical assessment model. This might take the operational schema presented on the next page.

Note the differences between the earlier figure and this one. First, the control group is actually made up of the numerous people in the community who continuously are searching for remedies to their ills. They would form the Daily Round Subject Pool, a group of interested persons in the community. The interests may, vary but to some extent at least, there must be an involvement in the study of social psychology. That is, an individual who is contributing data must be motivated to some extent by what the data is for, to begin with. Such specific interest is progressive from the point of view of an educational objective that stresses objectifying the self through systematic record.keeping on a day-to-day basis. Should members of the DR Subject Pool find some new treatment or change in diet, habits, etc. that help them function better, they certainly would not wish to end it if they believed in the validity of the treatment or new habit. This is a crucial feature which makes the technique we propose acceptable to the natural food movement and the various new healing practitioners as well as to the medical profession.

It harmonizes with that ideology which affirms the wholistic primary of the total environment, hence the emphasis on natural, day-to-day, habitual, and permanent changes in one's nutrition, exercise, mental attitude, spiritual strength. Thus, the proper design of a new medical technology, such as we propose, ought to integrate with this central notion. Note that t₁, is the period of search during which the subject suffers the symptoms, mild or critical, chronic or sudden. This requires a pool of subjects who regularly keep Medical Daily Round Reports. At some point, an individual is led into trying a treatment, device, or ingestible product. This would be noted in their AMR Reports; it marks the beginning of t₂. This "treatment" period may be long or short, depending on each case history. One subject may quit after a few days; another may go for years. Furthermore, one subject may carry out the new program assiduously and regularly, while another may do so irregularly. in all cases, the exact pattern is visible in the MDR Reports. The distinction between t₂ and t₃ is thus not based on the earlier and objectionable, sudden-death program of either terminating a treatment for data purposes, or initiating one for data purposes, all on a routine basis.

At this point, we introduce an experimental group. This is made up of volunteers from the Community Subject Pool who agree to act as experimental "subjects" for a pre-determined period. Note that these special subjects are not prepared or committed to the treatment: they are not, like the control group, independently motivated to search out the treatment in question. Instead, they are motivated by the wish to act as either compensated or unpaid volunteers in an experimental set-up. Thus, while they are acting as volunteers, they commit themselves to a cessation of the treatment exposure according to a pre-established schedule. For example, t₁ may be designated to start on Day X and to run for 6 weeks; then, t₂ begins and runs for 6 weeks; finally t₃ begins and runs for 6 weeks. In this manner, the experimental group's time table is superimposed on the control group's unscheduled pattern, so that the, periods t₁, t₂, and t₃ overlap for the two groups. This mechanism thus provides for the experimental/control contrast required by the classical medical model. The approach is therefore acceptable to all elements in the confrontation.

The methodology we propose here is a natural extension of the DRA approach outlined throughout this Workbook (see index), except that the kind of data to be kept by the individual contributor (or "subject") is more specialized (Medical Daily Round, MDR). We have already outlined the format of a general and functional analysis of one' s daily round dealing with "My Talk," "My Standardized Imaginings," it "My Community of Relationships," and soon (see Section [9.3] in Chapter 9). Now we need to construct a psychosomatic taxonomy of the daily round which would catalogue the most relevant features of a person's ability to keep track of variations observed in one's sensations, functioning, and "coloration," i.e., the background quality of one's state of general feeling. The following tentative inventory may serve as a starting point for evolving empirically a more suitable taxonomy.

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