Accurate differential diagnosis can save a life. By being able to determine clearly how one outlying factor or the combination of a group of signs and symptoms tips the scale to the correct pattern confirmation and treatment, our lives can be shaped, saved and lost in this qualifying lens of time. It’s integral to the practice of medicine, but also in many ways to how we make decisions in life. A positive or negative result, a clustering of symptoms, the ticked boxes and specimen samples that can reveal so much as to how we define our experiences of life and are able to move forward.

Differential diagnosis asks us to see what sets one pathology apart from all the other things it could be. The puzzle that pieces together who we are and who we are not, in pathology, a contraction and amalgamation of signs and symptoms. Seeking out and finding the determinant factors to prove our case becomes the way forward. But at what cost when the pathology we are looking for is now woven into life on such a scale as COVID-19? To rule in or rule out this sovereign virus, crowned in biological shape a reigning life changer for us all, this coronavirus, the monarch of plagues has left no lives unchanged, regardless of which box they land in.

As time progresses in the pandemic, I’m left to wonder what we have in common in this shared space of experience more than the clinical features that set us distinctively apart. How is the global community feeling the results of a positive test ripple out from what had been the assumed safety of a negative return. Instead of the singularity, the separate factor that creates a distinctive space, what is the commonality in this for us all? A restoration of hope perhaps, in the bigger picture, outside the boxes?

When I look at “Differential Diagnosis” (Spring 2020 Intima), the meditative artwork of Yan Emily Yuan, an internal medicine resident physician at Brigham and Women's Hospital doing an endocrinology fellowship there, I see its squares and lines separating a slide smear of bacterium from virus, crowned by shared blooms and think of how we are drawn together in this. The blossoms that can lead to the dreaded cough and congestion signs requiring the requisite rule-outs of allergies, cold, flu or COVID-19. The soft yet clear lines demarking one shape from another ask me to reflect on the place I’m living now—the blurred lines where symptoms meet. Not just as symptoms, but as people. As humans, living in a pandemic. Separated, sometimes isolated... and easily losing sight perhaps of what we share in our cells. Our humanity.

Colleen Corcoran practices in the field of Traditional East Asian Medicine at the University of Kentucky Integrative Medicine & Health. Prior to being in medicine, she had been in the arts with a BA in English Literature. “My heart is in combining it all to honor the human spirit and the story the body tells,” says Corcoran. Her Field Notes essay “What My Dying Father Taught Me” appears in the Fall 2020 Intima.