The CauseHealth Series: Chapter 9 - Causality and Dispositionality in Medical Practice with Prof. Ivor Ralph Edwards

Welcome to another episode of the Words Matter Podcast.

On this episode of the CauseHealth Series, I’m speaking with Dr Kai Brynjar Hagen about his Chapter 10 that he wrote for the CauseHealth Book, titled ‘Lessons on Causality from Clinical Encounters with Severely Obese Patients’ (read Chapter 10 here).

Kai Brynjar is a Senior Consultant in the Regional Centre for Morbid Obesity, in the North Norway. He is also General Practitioner, District Medical Officer for Communicable Diseases and as you can imagine has his handful advising on the current pandemic.

He is Specialist in Community Medicine and is interested in ecological thinking in medicine, from the individual person to the policy level. And he is interested in primary causes of obesity development and factors that contribute to maintain obesity, such as trauma or other stressors (see his work here).

So in this chapter we talk about:

• The different roles that he has within the Norwegian healthcare system and how these relate to his thinking around causation.
• We talk about his view of causation in relation to obesity and how the biomedical view and diagnosis of obesity is insufficient to fully understand the whole person and the causal processes at play.
• Kai Brynjar contrasts the biomedical diagnosis of obesity (which focuses on medical symptoms such as diabetes or psychcobehavioural aspects such as diet or motivation for physical activity.
• We talk about how he strives for what he calls a ‘genuine’ causal diagnosis for severely obese patients.
• He tells us about the challenges of adopting a Whole Person Approach in larger structural and institutional settings which in he’s worked.
• We talk about about the main focus of his clinical encounters with obese patients, which is understand their life story- including their life as a child, and the centrality that this dialogue plays in the creation of a story together with the person.

So, this was another resonating conversation, with a clinician at the front line of helping people with complex causal stories. His compassion, warmth and sincere interest in obtaining a genuine understating of his patients’ causal story reverberated during our conversation.

So I bring you Dr Kai Brynjar Hagen.

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