Daniel Dick gave a presentation in the framework of two workshop days at the Bertalanffy Center for System Science about “Health and Big Data”. Rising the question about the diagnosis seems to be an easy question at the first sight, but actually it is a question about how does a medical practioner know what he in his daily routine knows? This asks the question about the underlying structures of a professional consciousness and its implication of his work. Several theories and philosophies around the sign (symptom) and the interpretation (doctor) about an object of observation (subjectivity of pain) comes into a ploy-valent logic in place by thinking it with Formwelt of Gitta and Ralf Peyn and Peirce´s sign theory. But a step further: Our reference system in which knowledge takes place is only a part of our sense-making. The other part is in the contexture, which has been elaborated by Gotthard Günther. Still a lot to uncover, especially if the “here and now” is the fundamental principle of reality.