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Fast and slow thinking to say that not everything is Covid-19

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Fast and slow thinking to say that not everything is Covid-19

The elderly energetic former started to walk heavily. Together, he suffered from swallowing, with many gagging. When standing, it paled and collapsed. On the ground, he couldn't get up without someone else's help. It all started a few months ago and got worse slowly. She was taken by the children to the emergency room after an abrupt worsening, with fever and cough. Under emergency measures, she started to breathe with the aid of devices and was referred to the ICU.

The children transmitted divergent information to the team that attended the lady. For one of them, the mother, depressed, neglected to eat and, therefore, became ill. For the other, a sedentary lifestyle coupled with a craze for catching cold had weakened her.

One of the specialists in intensive care said that she would be the 16th hospitalized for Sars-CoV-2, in that hospital. However, chest tomography and initial symptoms were not typical of the disease. It didn't matter, he guaranteed the diagnosis. After all, he had read in a medical journal that, somewhere in the world, someone with a similar clinical picture had a pandemic disease.

Another intensivist replied elegantly: the weakness was due to anemia and there was nothing more than ordinary pneumonia. Diagnostic tests for Covid-19 were negative. For the first doctor, they were all false negatives. Furthermore, anemia was not at all serious for so much weakness. Both professionals were satisfied with each of their explanations.

The human brain when facing doubt uses two ways to process information to find the solution. One quickly judges the data and chooses which one to trust. It does this, generally, according to some rule "in the palm of the hand", to consider the previous experiences and the context.

When we face difficult issues, we often do not have all the data available. For these circumstances, intuitive judgment is appropriate because it is practical, saves energy and time. However, it is permissive for us to ignore certain analyzes and thus can lead us to error.

The other strategy is normative judgment. In this mode, the brain evaluates the information independently and together, assigns different weights to the data and then integrates them for the final answer. Normative thinking is analytical and methodical, heuristic reasoning is associative and automatic.

The two ways of solving problems do not work in a completely exclusive way, since some brain regions act in both processes. However, there are striking differences: intuitive thinking uses brain areas involved in pleasure, while the normative is preferentially established in frontal areas, implicated in reason. Another difference: those who prefer to use the normative form tend to have better short-term memory.

A third doctor decided to be normative. He realized that he did not have all the elements necessary to understand the case. He decided to seek them out through a long conversation with his children. The measure allowed the clinician to understand how the lady's symptoms occurred and to dismiss futile data. So, he suspected that there was a neurological disease and called a neurologist to help him.

The neurologist was lucky, examined the patient in a better situation and with a better story already told. At first glance, he noticed that the woman had droopy eyelids. It was the key that made him intuit the diagnosis – there would be a disease that caused weakness even in the eyelids. The loss of strength occurred even to swallow. The lady barely had the strength to shake the hands of the examiner. When standing, the blood pressure dropped, which caused pallor and almost made her pass out. What had brought the clinical worsening and the consequent admission to the ICU was a common pneumonia.

The diagnosis was Eaton-Lambert syndrome. Disease in which the nerve is unable to activate the muscle, hence generalized weakness. Sometimes it also affects the regulation of blood pressure, also mediated by nerves.

Knowing the disease improves your coping.

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