Tuesday, October 12, 2010

Eczema: not a "wicked problem," but not an easy one either

Voov's a wiggler on her diaper table tonight. As usual. You have to spread on her steroid oil and then her moisturizer while at the same time she grabs for her ankles, trying to scratch her feet. A trick I have learned: give her a toy, and somehow her brain focuses on playing with the toy, or her motor neurons are too occupied flinging that plastic giraffe around, for the itch impulses to dominate. Distraction works.

I find this true myself. If I'm intent on a crossword or working on a fiddly bike repair, the itch-scratch cycle gets turned off. Back in college, math problems would do the same thing--except there were always the problems I couldn't solve for hours, and the stress of having to finish a problem set on deadline would set off an itching spree. I must have been a sight in the exam hall.

That reminds me-- another temporary off switch for eczema itch-- rock climbing. It demands utter focus and your brain has no time to waste on itch. Years ago, I was into top-roping with friends, and I remember the intensity. Maybe I should get back into it. (Besides, climbers develop serious pipes.)

The neurology of itch is a weird thing, and science hasn't figured it out yet. Eczema's a super-complex problem because it involves itch, genetics, immunology, factors such as psychological stress and heat, and substances such as sugar, caffeine, and alcohol. To find a cure for eczema will take a first-class interdisciplinary research and clinical team. A dedicated institute, or a committed and collaborative group at a large research university.

I was thinking the other day that you could call eczema a "wicked problem." I was inspired by reading a piece on the internet that used the phrase. But it turns out that the author of the piece was misusing "wicked problem." He really meant "super-complex" problem. "Wicked problem" is a term from social planning that refers to a societal problem that you can't even describe unless you already know the solution--and which depend on your values and point of view, and the solution of which can cause unforeseen, unwanted consequences.

Curing eczema-- the originators of "wicked problem"would call that a "tame problem." Whoever finds the answer is going to make a lot of people happy for good. Unfortunately, "tame" doesn't mean "easy."

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