Departures from baseline have a direction. Something can be elevated
relative to your normal: faster, higher, more. Or it can be
suppressed relative to it: slower, lower, less. We name these
Yang and
Yin, and we require the
system to treat them as equal and opposite.
That requirement exists because real monitoring systems are rarely
symmetric. They are tuned, over years, by what people noticed and
responded to; what people notice is the loud direction. Agitation is
instrumented better than withdrawal. Tachycardia better than a
subtle downward drift. Escalation better than shutdown.
The asymmetry compounds into a fairness problem, because the quiet
failure mode is disproportionately the one experienced by people who
are already less likely to be attended to: the sedated, the
non-verbal, the exhausted, the very young, the very old, and anyone
who has learned that making noise does not help them.
This is a documented clinical pattern, not a turn of phrase:
see the hypoactive-delirium citation in the
disparity case.
Asymmetries in conventional monitoring, and the symmetric treatment
| Loud direction | Quiet direction |
| Agitation, restlessness | Withdrawal, flattening |
| Elevated rate | Sustained downward drift |
| Escalating behavior | Progressive shutdown |
| Acute spike | Loss of normal variability |
In a symmetric model, a given magnitude of departure from the
subject’s own baseline carries identical weight in either
column. Direction is preserved in the output, which is clinically
and behaviorally meaningful, but it never scales the severity.