Exploring The Rashomon Effect : A Psychological Prospective on Perception and Its Implications for Homeopathy in Understanding Patient Experiences and Treatment Outcomes
Recently, I immersed myself in a captivating video exploring the Rashomon Effect, where multiple perspectives intertwine, revealing the intricate dance of truth and perception.
Rashomon, the acclaimed 1950 Japanese film, intricately examines the multifaceted nature of truth through the retelling of a violent incident involving an outlaw, a woman, and her husband. Narrated by a passerby, the film presents four divergent accounts of the event, each shaped by the individual biases and emotions of the characters. While the basic facts align, the interpretations of motive and responsibility vary significantly, prompting viewers to critically assess the reliability of memory and perception. Rashomon remains a profound exploration of human nature, inviting audiences to engage with the complexities of subjective reality and the elusive essence of truth.
The Rashomon Effect, as explored by Davis, Anderson, and Walls, reveals how conflicting perspectives can distort scientific observations. This phenomenon highlights the subjective nature of data interpretation, suggesting that individual biases “Rashomon Effects: Kurosawa, Rashomon, and their Legacies,” this video explores its implications in social science, in war, in statistics , in law, in science, in healthcare ethics, in research, Homoeopathy is not an exception. For example The Rashomon Effect in legal contexts highlights the subjective nature of eyewitness testimony, where individuals interpret the same event differently based on their perspectives, biases, and interests. This phenomenon underscores the challenges of establishing objective truth in court, as varying narratives can significantly influence the outcomes of legal proceedings. Similarly In educational settings, this effect can pose challenges for students as they navigate topics with multiple perspectives and competing interpretations.
While viewing a video on the Rashomon Effect, I was struck by its profound relevance in our daily medical practice. This phenomenon is not just a philosophical concept but a daily reality in our medical practice. In the outpatient department (OPD), we often encounter situations where multiple perspectives influence patient care. Each postgraduate scholar, alongside attending physicians, engages in in-depth interviews with patients, navigating through pathological, miasmatic, and therapeutic diagnoses. At every juncture, we face conflicting interpretations and outcomes, reminiscent of the Rashomon narrative, this phenomenon highlights the subjective nature of perception in clinical practice.
This phenomenon challenges our understanding of truth and highlights the complexity of clinical decision-making, emphasizing the need for collaborative discourse in achieving optimal patient care and outcomes. Each stage of this intricate process, conflicting outcomes often emerge, challenging both scholars and attending physicians.
The Rashomon effect highlights the subjective nature of perception, illustrating how individuals can interpret the same event in fundamentally different ways based on personal perspectives.
The Rashomon effect illustrates the complex nature of human perception and memory, highlighting how individual experiences shape interpretations of the same event. This phenomenon underscores that differing accounts do not necessarily stem from intentional deceit; rather, they arise from the subjective nature of human cognition, suggesting that our memories are not mere reproductions of reality but are instead reconstructed narratives shaped by various factors, Factors such as personal biases, emotional states, and cultural backgrounds play a critical role in shaping these perceptions. Consequently, the Rashomon effect serves as a poignant reminder of the multifaceted realities of human experience, emphasizing the importance of considering diverse viewpoints to gain a more comprehensive understanding of any event. Understanding the psychology behind this effect is crucial for fields such as conflict resolution, legal testimony, and interpersonal communication, as it emphasizes the importance of acknowledging multiple perspectives to gain a comprehensive understanding of reality.
In the contemporary healthcare environment, patients frequently navigate a series of specialist consultations to obtain an accurate diagnosis. Each specialist contributes valuable insights based on their expertise, addressing specific facets of the patient’s symptoms. While this thorough approach can extend the diagnostic process, it underscores the critical need for interdisciplinary collaboration and comprehensive care in managing complex medical conditions. By integrating diverse perspectives and exploring various diagnostic possibilities, patients can achieve a more holistic and precise evaluation of their health issues, ultimately enhancing the quality of care and facilitating more effective treatment pathways.
A young adult with a complex medical history presents with chronic neck pain that has recently radiated to his left shoulder and arm. After consultations with three super-specialist physicians, a thorough diagnostic evaluation was conducted,
including ECG, ECHO, MRIs of the shoulder and neck, and a series of blood tests. His profession in IT likely exacerbates musculoskeletal issues.
The case presented underscores a prevalent challenge in healthcare, where super-specialists may concentrate exclusively on their specific domain, potentially neglecting alternative diagnoses or contributing factors. This situation emphasizes the importance of adopting a holistic approach to patient care.
The Rashomon Effect, as illustrated in Akira Kurosawa’s acclaimed film, underscores the subjective nature of perception and interpretation. In healthcare, this concept is reflected in the varied approaches that physicians from different specialties take regarding clinical notes,
diagnostic investigations, and disease management. Each practitioner applies their unique expertise and training, believing their perspective to be the most effective for patient care.
However, such specialized perspectives can inadvertently obscure a comprehensive understanding of a patient’s health, a concept akin to the Rashomon Effect, where multiple interpretations arise from a single scenario, highlights how different specialists can interpret the same symptoms in varied ways, potentially neglecting critical interconnections within a patient’s overall condition. Which Urges us to consider the interconnectedness of bodily systems and the multifaceted nature of health.
In the era of medical super-specialization, practitioners often approach clinical symptoms through the prism of their specific expertise, leading to divergent diagnoses. For instance, A gastroenterologist might interpret upper stomach pain as esophagitis, while a cardiologist might see it as angina, and an orthopedic surgeon could diagnose it as costochondritis.
In the realm of homeopathy, this phenomenon is particularly relevant and can be observed in the diverse interpretations of clinical outcomes. Patients often report varying experiences and outcomes from homeopathic treatments, influenced by personal beliefs, expectations, and individual health conditions. This variability can lead to polarized opinions on the efficacy of homeopathy. Such variability can be attributed to individual beliefs, emotional states, and unique physiological responses, highlighting the subjective nature of healing. Practitioners and skeptics often view homeopathic remedies through vastly different lenses. Supporters argue that these treatments, based on the principle of “like cures like,” offer holistic healing, while critics highlight the lack of empirical evidence supporting their efficacy. . In homeopathy, diverse patient experiences and symptoms influence treatment choices, ……. This divergence in perception underscores the complex interplay between personal experience, belief systems, and scientific validation, making homeopathy a compelling case study in the broader discourse on alternative medicine and human perception. This interplay of perception and treatment underscores the complexity and subjectivity inherent in both storytelling and healing practices.
how frequently we encounter this phenomenon in our daily practice, especially in the outpatient department (OPD). In the bustling environment of the outpatient department (OPD), each day unfolds as a complex tapestry of patient interactions, where postgraduate scholars and experienced physicians engage in the intricate dance of diagnosing conflicting outcomes that challenge their expertise and judgment. . Each patient we see, alongside our postgraduate scholars, presents a unique narrative shaped by their experiences. After thorough interviews and a series of pathological, miasmatic, and therapeutic diagnoses, we often face conflicting outcomes. Different perspectives can lead to varied interpretations of the same event.
Let’s understand with Examples…
CASE NO. 01
31 July 2024
Patient Case Report
Patient Information: Age/Gender: 37year/female
Presenting Complaints: Patients presented with the three-month history of pain in the epigastrium and right hypochondrium which is aggravated in the morning, on waking up and after eating.
Associated symptoms: bloating, belching, nausea and heartburn.
Recent endoscopy confirmed Helicobacter pylori infection and gastritis.
Mental Symptoms:
• The patient was very anxious and fearful about her condition, believing she might die from her symptoms.
• She has marked restlessness and is highly fastidious by nature, unable to rest when things are not in their proper place.
• Additionally, she becomes tearful when questioned and expresses a strong desire to recover as soon as possible.
• The patient was very worried about her family and continues to work even when she is unwell.
Discussion by PG scholars and physician in charge
Group 1: Dr kajal Arya batch 2021-22
Dr Abdul Rahman batch 2022-23
Observation: This physician focused on the patient’s marked anxiety, fear of death, and fastidious nature. They also considered the physical symptoms, including pain in the epigastrium and right hypochondrium, bloating, and heartburn, which are aggravated in the morning and after eating. The patient’s restlessness and need for things to be in order were noted.
Recommended Remedy: Arsenicum Album
Justification: Arsenicum Album is well-suited for addressing both the patient’s significant anxiety and physical symptoms. The remedy is indicated for individuals who are anxious, restless, and concerned about their health, aligning with the patient’s fear of death and fastidious nature. Additionally, Arsenicum Album addresses gastrointestinal symptoms like pain, bloating, and heartburn, which are aggravated by eating, making it a comprehensive choice for the patient’s condition.
Group 2: Dr Vaishali saxena PG scholar batch 2021-22
Dr Anshu Prajapati PG scholar batch 2022-23
Observation: This physician emphasized the patient’s emotional state, including her tearfulness, strong desire for a quick recovery, and worry about her family.
They also noted the patient’s persistence in working despite illness and her emotional sensitivity. Recommended Remedy: Sepia
Justification: Sepia is suited for patients who feel emotionally exhausted, indifferent, or overwhelmed, particularly those burdened by family responsibilities. The patient’s concerns about her family, persistence in working despite illness, and emotional sensitivity align well with the Sepia profile.
Physician -in – charge:
Observation: This physician highlighted the physical symptoms of gastritis and the associated pain in the epigastrium and right hypochondrium, while also considering the patient’s mental symptoms, particularly her marked anxiety and fear. Notably, the patient experiences overwhelming fear and anxiety in social situations, is low in confidence, and has a thermally hot constitution. Her gastrointestinal symptoms include bloating, belching, nausea, retching, and stitching pain in the abdomen. The symptoms are aggravated after eating.
Recommended Remedy: Argentum Nitricum
Justification: Argentum Nitricum is well-suited for patients with significant anxiety and gastrointestinal issues. The patient’s symptoms, such as bloating, belching, nausea, and stitching pain, align with the profile of Argentum Nitricum. Additionally, the remedy matches the patient’s overwhelming social anxiety, low confidence, and sensitivity to thermal changes. The remedy is indicated for conditions that are aggravated after eating, reflecting the patient’s symptom profile.
Conclusion: Each physician has provided a rationale for their remedy choice based on different aspects of the patient’s condition. Arsenicum Album addresses both anxiety and physical symptoms such as pain and bloating; Sepia targets emotional exhaustion and family burdens; and Argentum Nitricum is suitable for gastrointestinal symptoms and significant anxiety.
In such cases , A follow-up consultation will be necessary to evaluate the effectiveness of the chosen remedy.
CASE NO. 02
Patient Case Report
A 56-year-old female presents with a status asthma attack, persisting for three days, with a history of acute exacerbations over the past two years, particularly exacerbated during the rainy season. Symptoms include dyspnoea, continuous cough, wheezing, and increased respiratory distress at night and during travel, alongside a rise in body temperature.
Physical examination reveals a lean, emaciated, and unhygienic constitution. The patient reports disturbed sleep, thermally chilly sensations, thirstlessness, normal appetite, loss of taste, scanty perspiration, clear bowel movements, and normal urination. She expresses cravings for oranges,
chicken, and hot food, alongside experiencing cramps in her extremities when exposed to extreme cold.
Family history includes a deceased brother (accident), a sister with diabetes and hypertension, and a younger sister with diabetes and asthma ( familial diabetes and asthma). The patient is a nurse and she experienced significant stress after her husband’s death in 2004 due to myocardial infarction and chronic alcoholism.
Mentally, she is loquacious, extroverted, and exhibits a fear of fire
Constitutionally, she appears lean and unkempt.
This case involves a patient exhibiting significant symptoms across multiple domains, including religious preoccupation, asthmatic status, disrupted sleep, and general cold air aggravation. The primary rubrics identified include “mind: illusion, fire vision” and “sleep: disturbed.”
Remedies evaluated were Lachesis (8 marks), Lycopodium (10 marks), Arsenic (9 marks), and Graphites (9 marks), each covering various rubrics. However, Dr Vaishali , pg scholar batch 2021- 2022, suggested Sepia as the most suitable remedy, given its efficacy in addressing respiratory hypersensitivity to cold and its characteristic emotional profile of indifference, which resonates with the patient’s reported lack of affection towards her husband. Additionally, the patient’s desire for sour and acidic foods aligns with Sepia’s materia medica.
Overall, Sepia‘s comprehensive action on the respiratory tract and emotional state makes it the optimal choice for this case.
But Sulphuric Acid 1M was prescribed, administered once daily for three days, to address her thermal sensitivity and associated psychological manifestations by the physician in charge, based on symptoms and her unique temperament. The patient presents with a peculiar thermal chilly ailment, exhibiting heightened sensitivity to cold air and a compelling fear of fire. Characterized as loquacious and extroverted, she demonstrates a strong craving for oranges and a disinterest in household chores, reflecting an unhygienic lifestyle. Her behavior is marked by haste in both walking and talking. Despite her challenges, she expresses a desire to maintain her job.
In this case, Lachesis, Lycopodium, Arsenic, and Graphitis each addressed certain symptoms whereas Sulphuric Acid emerged as the most fitting remedy. Its alignment with the patient’s thermal sensitivity, extroverted mental state, and specific physical symptoms underscores its relevance, surpassing Sepia in capturing the totality of the patient’s presentation.
Such a dilemma where clinical intuition often clashes with empirical evidence, poses a significant challenge. Yet, amidst this chaos, the wisdom of remaining unbiased and unprejudiced, as our Master Hahnemann advised, while also trusting the intuition and instincts honed through years of experience. It’s a delicate balance we must master.
Conclusion
Navigating the complexities of patient care in the outpatient department presents a continuous challenge for both postgraduate scholars and experienced physicians. Each step—
be it pathological, miasmatic, or therapeutic diagnosis—can yield conflicting outcomes that test our resolve. The key to overcoming this dilemma lies in fostering an environment of unbiased evaluation and unprejudiced judgment. By embracing the wisdom imparted by mentors and trusting the instincts honed through experience, we can bridge the gap between conflicting diagnoses and deliver holistic care. Ultimately, it is this blend of science and intuition that will guide us toward effective, compassionate patient management.
The Rashomon effect vividly illustrates how varied perspectives shape our understanding of reality, akin to homeopathy’s personalized approach to healing. In homeopathy, the distinct experiences and symptoms of each patient guide treatment decisions, mirroring the unique stories that define their lives. Recently, two cases in our outpatient department beautifully illustrated this principle. In homeopathy, each patient’s unique experiences and symptoms guide treatment choices, reflecting their individual narratives. This concept was beautifully exemplified in two recent cases from our outpatient department. In one instance, a patient with chronic migraines reported relief through a remedy tailored to her emotional triggers, while another found healing with a different approach focused on physical symptoms. These cases highlight how the same condition can lead to diverse treatment paths, emphasizing the art of individualized care in homeopathy.
References:
• Same Redox Evidence But Different Physiological “Stories”: The Rashomon Effect in Biology Michalis G Nikolaidis et al. Bioessays.2018 Sep.
• Cite Nikolaidis MG, Margaritelis NV. Same Redox Evidence But Different Physiological “Stories”: The Rashomon Effect in Biology. Bioessays. 2018 Sep;40(9):e1800041. Doi: 10.1002/bies.201800041. Epub 2018 Jul 18. PMID: 30019441.
• Bioethics consultation: the Rashomon effect Miriam Piven Cotler. Med Law. 2013 Jun. Cite
Cotler MP. Bioethics consultation: the Rashomon effect. Med Law. 2013 Jun;32(2):205-12. PMID: 23967794.
• The Rashomon effect: organization ethics in health care Mary V Rorty et al. HEC Forum. 2004 Jun. Cite Rorty MV, Werhane PH, Mills AE. The Rashomon effect: organization ethics in health care. HEC Forum. 2004 Jun;16(2):75-94. Doi: 10.1023/b:hecf.0000037120.40045.05. PMID: 15352334.
• The Rashomon Effect November 2002Sociological Methods & Research 31(2) 31(2)
DOI:10.1177/0049124102031002002 Authors: WENDY D. ROTH Jal Mehta Harvard University Researchgate Article PDF Available
