There is both a science and an art to medicine. The “art” part usually comes into play when we talk about bedside manner and the doctor-patient relationship, but recognizing and naming diseases — diagnosis — is also up there. José Luis Ricón wrote recently about a fairly discrete entity, Alzheimer’s disease, and how several different paths may lead to a similar phenotype. This is true for most diseases.

But take something like “cytokine release syndrome”, or “HLH”, or any other syndromic disease that is more of a suitcase phrase than anything, and that can present as a spectrum of symptoms. Different paths to different phenotypes, with only a sleigh of molecular storytelling to tie them together. Yet somehow it (mostly) works. It’s quite an art.