There is a quote from Carl Jung that I absolutely love:
This is brilliant, particularly for chiropractors, because we can become incredibly good at theory.
We can debate biomechanics, neurology, subluxations, pain science, rehabilitation, inflammation and nutrition.
We can attend seminars, read papers and construct increasingly sophisticated explanations for what is happening to our patients.
But ultimately there is a patient standing in front of us.
And something either changes, or it doesn’t.
There is another quote, commonly attributed to Ayn Rand:
Which brings me to ACN Core Commandment 10:
Beware the certainty trap
We naturally crave certainty.
How many seminars offer to give you “certainty” on your adjustment?
We want to know that our diagnosis is correct, our technique works, our nutritional model is right and our explanation of the patient’s symptoms is the explanation.
But absolute certainty can become the enemy of curiosity & truth.
Because the moment you become certain you already know the answer, you stop looking for it.
You stop being curious.
You stop asking, “What else could this be?”
You stop looking for evidence that might prove you wrong.
And eventually, you can find yourself interpreting the patient through the “lens” of your beliefs rather than allowing the patient reality to challenge them.
That is the certainty trap.
The Polish American thinker Alfred Korzybski gave us brilliant concept:
“The map is not the territory.”
Korzybski introduced the concept in 1931. His point was essentially that our representations of reality are not reality itself.
A useful map has a similar structure to the territory, but inevitably leaves things out – it is a simplification of something infinitely complex.
And isn’t that a wonderful analogy for healthcare?
Research gives us maps.
Clinical guidelines give us maps.
Diagnostic labels give us maps.
Our favourite chiropractic theories give us maps.
But maps are not the patient’s individual reality.
The patient is the territory.
This is something I think can occasionally be forgotten within teaching institutions.
It is relatively easy, from an academic or research ivory tower, to construct increasingly elaborate or reductionist theoretical maps of how patients should behave or respond.
Meanwhile, clinicians are the explorers actually walking the terrain every day.
We meet the patient who doesn’t respond as the model predicts.
The patient whose symptoms don’t fit neatly into a diagnostic box.
The person whose blood results are technically “normal” but whose clinical presentation makes us question whether that really tells the whole story.
That doesn’t mean we dismiss academia or evidence.
Quite the opposite. We desperately need good maps.
But when the map and the territory don’t appear to agree, the answer shouldn’t automatically be to insist that the territory must be wrong.
It should make us curious.
Measure something meaningful
This is why I constantly encourage chiropractors to objectively assess their patients.
ROM: quantity and quality.
Muscle strength.
Pain.
Then:
TEST → TREAT → RE TEST → REPEAT.
If you believe your intervention improves cervical rotation, measure cervical rotation.
If you think it changes muscle function, test muscle function.
If you believe your patient is improving, periodically demonstrate that improvement rather than simply assuming they are because they keep returning.
And then ask:
Are those improvements sustainable between visits?
A patient moving better ten minutes after treatment is interesting.
A patient still moving and functioning better several days later tells us considerably more.
That is walking the territory rather than merely studying the map.
Blood tests are maps too.
We see the same thing in nutrition.
Take vitamin B12.
A simplistic interpretation might be: B12 is inside the laboratory reference range, it is “normal”, therefore B12 isn’t the problem.
But reality is more complicated.
As I discussed in a previous ACN article, research in apparently healthy older adults found that neurological differences were detectable across B12 concentrations that would not necessarily have been classified as deficient.
That doesn’t establish that a B12 result between 133 and 500 pmol/L always causes dementia, but it does challenge the certainty that being within a laboratory reference range automatically means neurological adequacy.
The reference range is another map.
Useful? Absolutely.
The territory? No.
I have seen many patients in the “normal” range, with debilitating fatigue, brain fog, pain, tingling, numbness, anxiety, who had huge improvements IN Health with LIPOSOMAL HYDROXOCOBALMIN.
Be confident, but remain curious
Patients don’t want a clinician who simply shrugs and says, “I don’t know.”
They need confidence.
They need an explanation that makes sense, a clear plan and confidence that you know what to do next.
But there is an important difference between clinical confidence and absolute certainty.
A master clinician might say:
“Based on your history, examination and what we currently know, I think this is the most likely explanation. This is what I recommend we do, and then we’ll assess how you respond.”
That is not indecision. It is good clinical reasoning.
In many situations, treatment itself can be both therapeutic and diagnostically informative.
We form a working hypothesis, intervene appropriately and observe what happens.
Does their pain change?
Does movement improve?
Does strength return?
Do those changes persist between visits?
The patient’s response provides another piece of information, allowing us to strengthen, modify or occasionally abandon our original hypothesis.
This is what I mean by living on the edge of clinical uncertainty.
It isn’t practising without confidence.
It is being confident enough to make decisions while remaining curious enough to change them when the evidence in front of you changes.
Use the research. Learn the theory. Study the maps.
But then go and explore the territory.
Assess. Form a hypothesis. Intervene. Re assess.
Stay curious.
And when reality consistently disagrees with your theory, don’t ignore reality to protect the theory.
Because the aim isn’t to prove ourselves right, it is to IMPROVE ourselves and the care we deliver.
It is to get the patient better.
To walk with them on the road to recovery, on their personal, bespoke journey.