• Jena Martin MD


What is the name of your disease?

Nosology is the act of naming and classifying disease. (No, I don't mean Nose-ology, which actually does exist 👃🏽) .

Disease can be classified by symptoms, by the damage it does, or the most satisfying - by the cause.

I love nosology - creating order from chaos. That’s what I do - I decide what things are. My job is to categorize, identify and describe all of the diseases in the human body. I’m a pathologist, and I make decisions everyday to accurately diagnose your diseases.

And I love naming and classifying disease based on causes. It’s the best way to understand and develop rational treatments. I see many peddlers of pseudoscientific cures who get their assessment wrong at the root cause, and mistakenly classify disease based upon secondary effects. Or they've put too many symptoms together to create a grand and unifying cause for all illness. Then they can sell you the all-purposeful tonic (hint: there is no such thing as an all purpose tonic).

We often don't think much about how things are classified, unless there is an obvious mix up.

(Um, Spotify, while this might be a new classic, pretty sure it is not Classical.)

Classification though is at the root of our understanding of the world. Your knife collection, your music collection, your desktop and your clothing drawers have all been categorized by you. What criteria are you using to categorize your items? You might not even be aware of what similar features each category shares, what made you put them together.

In much this same way do biologists and scientists sort out the natural world. Which, by the way, includes us. We humans, with our computer like brains, are part of the natural world.

When I categorize things, I am trying to make the chaos of our world bearable. I have to see the gestault, gist view first. This kind of thinking makes me a lumper, as in I like to lump categories together. The world is too fragmented. We need consolidation to bring order.

There are people who feel differently, and they are called splitters. Splitters on the other hand perceive that things as they are are too jumbled and opaque - they must first separate things to better analyze them and thus bring order.

These inelegant terms, LUMPER and SPLITTER, describe two basic tendencies of humans when we categorize things. We tend to want to put things together (Two things are in the same category unless there is some convincing reason to divide them), or apart (Two things are in different categories unless there is some convincing reason to unite them). It seems we humans are naturally inclined to be one way or the other. We see basic divisions with variations, or multiple integral variations. It's important to note that no one does either of these all the time - our tendencies emerge when we are faced with something unclear. Even describing these kinds of people might be the mark of a lumper - surely there are many many kinds of categorization!

This dichotomy is typically explained in Biology courses, and the terms arose even before Darwin. If you're reading this and are a student of the sciences you may have heard it before. But if not, it has relevance outside of Biology. Anytime we seek to categorize our world, we can fall into these camps.

Some questions for you to consider from 'real life':

  • When faced with five subtly different things, would you rather see one page with a general description of all five, or five pages precisely describing one entry each?

  • All things being equal (cost, weather, time) would you rather do your back to school shopping at an inclusive department store or visit several specialized boutiques?

  • Do you use one knife for everything, or do you have a separate knife for each item? (i.e. Chinese practice would indicate using a cleaver for everything).

I can think of more controversial examples too - areas where we might paint people with too broad a brush to make sense of what we perceive to be disorder. Stereotypes about behavior help us manage our perceptions - but can diminish our relationships and harm other people if there are power imbalances. Simple awareness of our distortions can help mitigate the worst effects of crude categorizations. Like everything with a roots in biologically determined differences, categorizations are not inherently wrong and bad - rather, it's our culturally-shaped brains that make anything so.

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