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REPORT ON CASE TAKING SEMINAR BY Dr. DHIRAJ NANDA
On 25/01/09 Shivanson Publications conducted a
seminar on Case-taking at Hotel Taj Homes, Secunderabad.
The seminar was attended by delegates from 5 different
states.
Dr. Sushama started the seminar with welcoming
delegates. The inaugural session consisted of garlanding
of the photograph of Dr. HAHNEMANN and lighting of lamp
of knowledge by Dr. S. K. Vashisht, a senior homoeopath
from Hyderabad and proprietor of Vashisht
Pharmaceuticals. It was then followed by a few words of
introduction of the speaker of the day-Dr. Dhiraj Nanda.
The short inaugural session was immediately followed by
Dr. Dhiraj Nanda who spoke on case taking in the entire
day long seminar. He explained that case-taking is a
very small term used to call the process of receiving
information from the patient. Being classical
homoeopaths it should rather be called as
case-perceiving where we perceive the man in the
disease. He even quoted the Aphorisms where Dr.
Hahnemann had explained about these points. Dr. Nanda
then explained what constitutes man and how to perceive
man in disease.
Here he divided case-taking/case-perceiving into 3
parts: Pre-Interview, Interview and Post-Interview.
Explaining the pre-Interview, Dr. Nanda said case-taking
starts even before the patient enters our consultation
room or even before we have asked our first question to
the patient. The points that we take notice of here are
definite pointers to the state or disposition of mind of
the patient. He explained these with certain examples
and pointers and even explained the rubrics that depict
each of these behaviors. Here, a case was shown which
was treated and cured by Dr. Nanda in his experience
based on pre-interview observations.
Talking about interview he said when a patient comes to
you for the first time you should be like a blank paper
as what do you know about the constitution that is in
front of you? You should start from the beginning and
understand the man in the disease who has come to you. A
classical homoeopath should give an indirect message to
the patient that he does not know anything about the
patient before the interview, to get full details from
him. For this we should allow the patient to talk and as
a classical homoeopath one has to play at least three
roles: listener, observer and recorder. What the patient
says may not be as important as how he says. Never
interfere when the patient is talking and remember to
use minimum words which give you freedom. For this he
even quoted some examples of his experience which
clearly explain this aspect of case-taking. He then
explained the importance of observations and pauses that
occur during the interview part of case-taking with
certain cases of his experience.
While explaining the importance of post-Interview he
explained that post-interview comes after you have
closed the interview session and is a part or extension
of the main interview. It has two main objectives, first
to probe in details of information that remained
incomplete during interview; and second to confirm the
important findings to the interview session. He even
said that post-interview session may be longer than the
interview. Here, we need to ask open-ended questions,
inductive-deductive questions or confirmatory questions
depending on the case.
The morning session was followed by lunch. All the
delegates were very satisfied with the seminar as well
as the food.
Post-lunch session started with a case being given to
all the delegates to analyze according to their
understanding and were given half-an-hour time for it.
In Post-Lunch session, Dr. Dhiraj Nanda talked about
four different methodologies of case taking. They were-
silent listening; observation; deduction; and induction.
Silent listening: It is a state of attentively hearing
what the patient is communicating to us. This attentive
listening will provide us the vital information that can
be converted into an appropriate rubric that will be
applicable to the patient. He gave many examples with
interpretation of rubrics which were very helpful in
practice.
Observation: It is study of patient by surveillance,
viewing, watching and monitoring him. He even quoted the
aphorisms where Dr. Hahnemann had mentioned the
importance of observation in case-taking. If
observations are contradictory to what patient is
telling, observations should be given more importance,
as what we observe is definitely more reliable. He gave
different situations and explained what rubrics apply to
those behaviors observed. He even gave some observations
of few remedies which he observed in his long years of
practice.
Deductions: It is interpretation or assumption or
presumption based logical or reasonable inference. One
can deduce from observations, past history, and by
method of inductive deduction. Dr. Nanda has explained
how to deduce rubrics from each of the above aspects in
detail and in a very understandable way with examples.
Induction: It is the method in which we initiate or
stimulate the patient to generate the history. Here the
doctor stimulates the patient to come out with some more
details of some aspect of his personality or history. He
even explained the different methods of induction-as
hitting at the observed trait in opposite, hitting at
the observed trait directly, inducing him to speak what
he likes about himself and other, and inducing him to
speak what he dislikes about himself and other etc.
Finally, he explained when case-taking is to be
considered to be complete with two cases from his
experience.
The entire session was very interactive with active
participation of most of the delegates during the
sessions and question-answer session at the end.
(Report by Dr. Sushama) |
