Georg Ivanovas From Autism to Humanism - systems theory in medicine
The analogy of ‘map and territory’ dates back to Alfred Korzybski. He introduced it to denote that there is a difference between a thing and its name, between a perception and its description, or between my neighbour and my opinion of her. The basic statement “the map is not the territory” aimed to explain the perception of schizophrenic people, as they tend to confuse the two (Korzybski 1941). This confusion is nothing else than the confusion of Russell’s class and its elements..
The picture of ‘map and territory’ was very successful and became, after its introduction, widely used in the scientific discourse. It was especially Bateson who applied it to depict all sorts of logical problems. Biologists, he said, studying living processes “create their descriptions, for even their most objective recorded data are artefacts of human perception and selection. A description can never resemble the thing described above all, the description can never be the thing described” (Bateson/Bateson, 1988: 151).
This tool of ‘map and territory’ can be developed further to illustrate medical perception:
No map, as Bateson already referred to, can ever depict all qualities of a territory. The map only considers certain aspects.
Therefore different maps exist: geological, climatic, social or road maps. Every map is linked with a certain question. We could say that every map is a different answer to the undecidable question “How is the territory?”. The instructions how to read the map, is laid down in the so-called legend. The legend is not part of the map, it is under the map or on a different page. It might even be missing, when it can be assumed that everybody knows how to read the map.
This depicts the known fact that the decision, how to interpret a content is laid down in the frame. It is never part of the content. This is often confused with objectivity. A geological map is not more objective than a climatic map, it is simply different.
The same is true for a diagnosis. A diagnosis based on physiological processes is not more objective than a diagnosis based the genetical disposition, on concepts of behaviour or on social communication. They only describe a content with different means. However, one might be more appropriate than the other in a certain context.
The already cited confusion whether a symptom or a diseases is treated (chap. 3.2) can clearly be solved with this tool. As diseases are maps and symptoms are points on a map, neither is treated.
Treatment concerns the territory (the patient). This will be further elaborated when it comes to the organisational closure of living systems (chap. 4.8).
Logically it can be said that treating a diagnosis would be the same as drilling oil on the geological map that helped to find an oil field. Mostly this fine distinction is not of importance. But one has to be aware of the fact that we are not working with truths in medicine but with concepts.