Victoria: Dialogue in medicine and health.

DIALOGUE AND NOT DIALOGUE.
Part 1.
WHAT DIALOGUE IS NOT

1. DIALOGUE IS NOT A LECTURE

In Western medical schools, students are often trained to memorize knowledge from textbooks and published studies, and then apply it to patients. Rarely are students encouraged to question or doubt the foundations of science. Science is often regarded as truth, and previous conclusions are almost accepted as absolute.
In Eastern medicine, macrobiotics, and some other medical systems, a similar tendency exists. Personal knowledge and experience are condensed into doctrines, treated as truths, then passed on and applied to patients.
However, all knowledge and experience have limits. If we only operate within what is known, we remain confined by those limits. To approach the infinite, to reach the root causes of disease or the deep disorders of human beings, we must recognize and transcend the boundaries of what we know.
Dialogue is not about transferring additional knowledge, but about observing together what is not yet known.
________________________________________
2. DIALOGUE IS NOT A CONCLUSION

Conclusions are always based on what is already known. Once a conclusion is reached, listening stops; further inquiry also ends.
In medicine, doctors often give a conclusion after examination and tests. For example, a patient comes in with a headache; the doctor measures high blood pressure and concludes that hypertension is the cause.
But if we ask deeper questions:
• Does high blood pressure cause headaches?
• Or do headaches raise blood pressure?
• Or are both consequences of another cause?
Concluding that hypertension is “primary” or “caused by a genetic mutation” and prescribing lifelong medication is dangerous, because once a conclusion is reached, the root cause is no longer investigated.
In Eastern medicine, macrobiotics, or other alternative approaches, the same occurs. For instance, if a patient has cold hands and feet, it may often be concluded as Yin-cold caused by exposure or improper diet. Treatments to expel cold through food or therapy are then applied. These actions are still based on what is known and may be misdirected, addressing only consequences without reaching the root cause.
Dialogue does not end with conclusions; it opens continuous inquiry.
________________________________________
3. DIALOGUE IS NOT FOLLOWING PRE-SET INSTRUCTIONS OR ROUTINES

Most of us are born and raised within routines already laid down by predecessors. Doctors follow medical guidelines; patients follow doctors’ instructions.
Clinical guidelines are built from past templates and experience, and therefore are limited.
For example, when a doctor finds high blood pressure, the next steps often involve blood tests, ultrasound, ECG, X-ray… These steps are pre-programmed based on what is already known.
If hypertension or headache is only a consequence of a deeper cause—such as prolonged stress or suppressed anger—these tests only address the consequences without reaching the root cause.
Similarly, in Eastern medicine, patients with high blood pressure often use herbs to reduce it. For back pain, acupuncture, physical therapy, or other symptom-focused methods are applied, but the deeper cause is rarely considered.
Confusing consequences, secondary causes, and root causes, and then concluding and treating long-term, misdirects diagnosis and treatment.
Likewise, if a patient has fever and fatigue, a positive PCR test may lead to the conclusion of viral infection and “no treatment available.” If a tumor is biopsied and abnormal cells are found, it may quickly be concluded malignant with a poor prognosis.
If tests only address consequences and lead to “untreatable” conclusions, this is extremely dangerous.
In many cases, if doctors accompany patients in observing life, psychology, and environment, deeper causes of pain, fever, or tumors can be seen.
________________________________________
4. DIALOGUE IS NOT EXPRESSING PERSONAL OPINIONS OR DEBATING RIGHT AND WRONG

When each person defends their own viewpoint, dialogue remains confined within personal limits. This often leads to conflict and ends further inquiry.
In practice, Western doctors, Eastern practitioners, macrobiotic therapists, or other schools often believe they are right and others are wrong. As a result, there is no listening, no connection, and no comprehensive understanding of the issue.
For example, some Eastern medicine practitioners may believe that drinking salted lemon can treat certain conditions such as hypertension or acid reflux, based on observation in some cases. Conversely, Western doctors may consider it dangerous, also based on past complications. Both rely on personal experience and defend their positions.
Dialogue requires letting go of one’s own sense of being right and not attempting to prove the other wrong, but instead sitting together, questioning based on actual facts, to explore the whole truth and the root causes. Why might drinking salted lemon reduce symptoms? Perhaps if the cause of hypertension relates to mental factors, and the patient believes in this method, symptoms may temporarily improve, similar to taking antihypertensive medication. However, such improvement is often temporary and does not address the root cause.
________________________________________
5. DIALOGUE IS NOT ANALYSIS, CRITICISM, BLAME, OR STORYTELLING

In many exchanges, each person mainly presents their own story.
Analysis, criticism, blame, or storytelling relies on past knowledge and experience to reinforce personal views. These activities strengthen the illusory self and psychological time, creating more separation, but do not lead to real solutions, as they still do not reach the root cause or reveal the essence of the problem.
They may clarify the issue logically, but do not touch the fundamental transformation.
________________________________________
6. DIALOGUE IS NOT SEEKING, PERSUADING, OR DESIRING

If dialogue aims to achieve results, solutions, or new beliefs, the mind is already directed. When there is desire, we are no longer truly listening.
True dialogue is voluntary, non-coercive, non-persuasive, and an observation without purpose, allowing truth to reveal itself.
________________________________________
Part 2
DIALOGUE AND RELATED FACTORS

1. YOU AND I ARE NOT DIFFERENT

You and I, whoever we are, anywhere on this planet, are fundamentally not different. We all carry disorders of body or mind, troubles from family and social relationships. Many disorders existed before we came into this life. No problem exists in isolation. Everything is interconnected and interacts. This has become more evident than ever in today’s era. Epidemics or wars are no longer the story of an individual or a nation, but a matter of all humanity—including you and me.
Therefore, we need to sit together. I need you, and you need me.
If we only sit to debate right and wrong, criticize, blame, or preach pre-existing theories, the problem is not only unsolved but also creates division and conflict. The result is broken connection—a reality happening within and around us.
________________________________________
2. DIALOGUE AND WORDS

Life requires connection, bonding both inwardly and outwardly. Dialogue is the connection formed through words.
(Dialogue: dia – through, logos – word; words are used to go beyond barriers and connect human beings.)
Words become limiting when we cling to them. Therefore, whether we call it dialogue, discussion, or companionship is not important; the name is not the core.
In medicine and health matters, dialogue is vital, as it touches the existence of the human body. Abnormal signs of the body—what medicine calls symptoms or diagnoses—become “problems” when they are blocked, not understood, or unresolved. Here, the need for dialogue arises.
Typically, when approaching a problem, words are used to argue, analyze, conclude, criticize, or lecture—always based on pre-existing thought patterns, and therefore inherently limited.
In contrast, in dialogue, words are used to directly question what is occurring. Here, words are no longer imprisoned in a fixed framework.
________________________________________
3. DIALOGUE ABOUT MEDICINE AND HEALTH

We can have dialogue about any issue, because all issues are interconnected.
When we understand the operating principle of one problem, we can reflect it in all areas of life.
We usually start with what is familiar and recognizable: eating habits, physical activity, signs of fatigue, pain, or fever. The body is the most concrete and clear place to observe.
When awareness deepens and no longer depends on words, dialogue naturally settles. Understanding how pain operates in the body allows one to touch the operation of the entire universe—a continuous, unified flow beyond any description.
Therefore, experience it yourself rather than merely listening to others. Words, no matter how refined, are always limited.
________________________________________
4. DIALOGUE: PURPOSE OR METHOD

Purpose and method arise from what is already known. Dialogue, in contrast, starts from the unknown; therefore, it does not operate according to fixed purposes or methods.
For example, when a patient is diagnosed with hypertension, the familiar process is to find causes through blood lipid tests, renal artery ultrasound, or investigating genetic factors like mutations…
This is a process based on existing knowledge: research, diagnosis, treatment—a loop of the known, and therefore inherently limited.
Specifically, both purpose and method are programmed from existing knowledge, leading humans within familiar territory.
Dialogue does not follow that path. It is an open approach, directed toward the infinite, unbound by fixed purposes or methods.
________________________________________
5. DIALOGUE: DIAGNOSIS AND MEANS

Most patients visiting a doctor want a clear diagnosis and specific means of treatment for their illness.
We do not deny the role of means and methods: medicine, imaging, surgical tools… all are necessary at the right time.
If everything is clear—when to go to the hospital, when to use medicine, when surgery is needed, what the cause is—then there is nothing more to discuss or dialogue about.
But when both patients and practitioners cannot truly accept conclusions such as “cause unknown” or “must take medicine for life,” they also cannot accept means that only address consequences. Here, the need for dialogue becomes unavoidable.
True dialogue begins with doubt—doubt about diagnosis, about treatment methods, and about what is regarded as the final conclusion.
• Do viruses really exist as we think?
• Why are there diseases with unknown causes?
• Why must some medicines be taken for life?
• Where do the studies come from and who funds them?
• Do final results really benefit the patient?
If you completely trust the doctor’s statement that hypertension is primary and must be treated lifelong, you may continue on that path. But if you do not accept it, you have the right to doubt, and we can sit together to explore.
________________________________________
6. DIALOGUE BEGINS WHEN WHAT WE KNOW ENDS

When sitting together without personal concepts or beliefs, illusions of certainty and psychological time cease. At that point, we are together on the same boat, without conflict or contradiction.
True dialogue only occurs when what we know ends.
________________________________________
7. TRANSCENDING THE LIMITS OF WORDS OR DIALOGUE

Transcending the limits of words does not mean rejecting them.
“Wordlessness” is not silence to escape life, withdraw into quiet, or deny action. Such forms, if present, are only avoidance or subtle illusion.
When dialogue becomes repetition of theory, clinging to words, or an act of seeking and desiring, dialogue itself is limited.
True dialogue arises from the needs of living events, not confined to a topic or a meeting, but present in all aspects of life.
When the principle of a problem is understood, the principle of all problems can be seen. When the root is clear, the problem is no longer a problem; dialogue is no longer dialogue.
There, the separation between “I” and “you” disappears, and the disordered reactions of thought cease. Words—or dialogue—remain only as a continuously fresh connection, expressed naturally through awareness and behavior in daily relationships.