One could say that the general practitioner adopts a holistic/integrated/systemic view of medicine. Faced with even the slightest ailment, they are prepared to anticipate its most serious repercussions, utilizing the full range of body parts and medical knowledge. That is, if consulted about shin splints, they immediately anticipate thrombosis; if consulted about foot problems, they suspect possible Parkinson's disease. It's good that many diagnostic resources are available, but that is not at all what is meant by holism/integration/a systemic medical approach. As these are difficult concepts to understand, apply, and teach, culinary metaphors are used here to explain them, and a glossary is presented: 1) Holism ("The Meatball"): It is a fusion. The individual ingredients (meat, breadcrumbs, spices) lose their identity to form a higher entity. The flavor is the result of synergy. The whole is unity. You cannot see where the meat ends and the breadcrumbs begin; the flavor is total fusion; 2) Comprehensive/integrated ("Thali"): It's a complete collection. Each element is distinct and perfectly placed, and its value lies in the fact that the selection is so broad that no gap is left unfilled: sweet, salty, bitter, sour, spicy and astringent. It is the completeness. You have protein, carbohydrates, vegetables, and fruit; everything is present and organized, but each element maintains its separate physical identity (a large tray containing a variety of small plates); 3) Systemic ("Risotto"): Relationships. The parts are distinguishable (you can see the grain of rice), but their state and flavor depend entirely on their active and constant interaction with the other ingredients.

One might say that family doctor/general practitioner (GP) takes a holistic view of medicine. "For the smallest ailment, she is ready to think ahead to its furthest possible repercussions through the entire range of bodily parts and medical knowledge." That is to say, consult her about a swollen shin bone, and she immediately anticipates thrombosis; go to her about feet, and she suspects possible Parkinsonism. Having access to the diagnostic resources of Western medicine is valuable, but this is not at all what is meant by medical holism/ comprehensive/integrated/ systemic thinking [1]

Holistic ("whole," "entire"; "the whole is more than the sum of its parts") and comprehensive/integrated ("total" or "complete"; something that includes all the elements necessary to be complete; it seeks to leave "no stone unturned," ensuring that every specific aspect is addressed) are synonymous terms in practice, and both refer to considering something as a whole, complete, or total. Both approaches seek to understand the interconnectedness of all parts (physical, mental, emotional, and spiritual) rather than focusing on just one of them. Although often used interchangeably, holistic and integral have different philosophical and practical nuances. The main distinction lies in whether the approach focuses on the "whole" as a unit (holistic) or on the "sum of all parts" to complete a system (integral). Jan Christian Smuts, in "Holism and Evolution" (1926), coined the term holism. Prior to the economic depression on Wall Street, this South African statesman formulated the first definition of holism in 1926: "It is a process of creative synthesis or progressive construction of increasingly complex structural units that tend toward the formation of a whole." With the term "holism," he described nature's tendency to form "wholes" that are greater than the sum of their parts. He proposed that evolution is a creative process driven by the unification of structures, from inorganic matter to complex organisms and the human mind, influencing each other [2-4]. Holistic: Focuses on interconnectedness. For example, a holistic approach to health; that is, looking at the whole individual. Comprehensive: Focuses on total coverage. For example, a comprehensive/exhaustive review of the data, without leaving out any detail [5]. Finally, systemic thinking is a comprehensive plus holistic approach that analyzes the interconnected elements of a system to understand its complexity. These concepts, which are fundamental for the GP, while intellectually understandable, are not easily visualized in daily practice and are difficult to explain to trainees. Metaphors allow us to understand something unknown in terms of something more familiar. This is why they are a common resource in all sciences, which use everyday words to name complex realities. Metaphors (which include analogies, similes, and models) are cognitive tools by which something unknown is understood in terms of something known [6-8]. Thus, three culinary metaphors are presented here which can help to understand and visualize these three concepts.

This article is a personal viewpoint; it aims to reflect on, conceptualize, and propose, based on a selected narrative review and the author's experience.

The GP's holistic, comprehensive/integrated and systemic understanding of patients, as well as the comprehensive treatment of physical and mental health problems, is a theoretical concept that can be grasped intellectually but is difficult to visualize. Metaphors help us in this endeavor [9]. Thus, a group of gastronomic metaphors related to these concepts could be described:

1. A simple everyday metaphor for holism is the culinary metaphor of the “meatball.” A meatball is a ball of minced meat mixed with eggs and seasonings. The meatball is a mixture of different components—pork, beef, ham, egg, etc.—previously minced or finely chopped, coated in flour, fried, and then stewed. Once cooked, it is impossible to separate the ingredients of the meatball. It is like organic and mental illnesses; they are so inextricably intertwined that they cannot be separated. If you eat one, you are also eating the other. Physical and mental health problems are inextricably intertwined, and improvement in one improves the other. Although some health problems are predominantly organic and others predominantly mental, and differential interventions may be appropriate, a comprehensive understanding of this clinical spectrum can enable effective interventions. However, "the cost of cooking meatballs is medium to high"; it requires appropriate tools specific to general medicine: continuity of care, the doctor-patient relationship, contextualization, a biopsychosocial perspective, etc. [10-15].
2. If the meatball represents holism (where the ingredients are mixed and transformed to create a new whole where the "whole" is what matters), the best culinary metaphor for comprehensive/exhaustive would be a thali (the traditional Indian platter). In a thali, you have different dishes (curries, rice, bread, yogurt, dessert) served on the same platter. It is "comprehensive" because nothing is missing; It comprehensively covers all food groups, flavors (sweet, salty, spicy), and textures. Unlike a meatball, here each element maintains its own identity, and you can see exactly what the whole contains: a large tray containing a variety of small plates. It is a complete and organized sum of individual parts. Wholeness reflects the uniqueness and unity or integrity of human beings and their environment (16). There are several theoretical dimensions of Wholeness in general medicine [17, 18]:
   • Primary health care (PHC) is defined as the provision of integrated services by physicians who are responsible for addressing the vast majority of personal care needs, developing a continuous partnership with patients, and working within the family and community. It is one of the four basic characteristics of PHC, along with accessibility, coordination, and longitudinality/continuity of care.
   • PHC provides comprehensive health services, including health promotion, disease prevention, curative care, and end-of-life care, integrated and coordinated according to each patient's needs. Comprehensiveness is understood as a set of concepts related to greater multidisciplinary care.

3. Comprehensive care must address the biological, psychological, and social aspects of each patient. As a principle, comprehensiveness implies understanding the patient within different contexts, from biopsychosocial, cultural, and spiritual dimensions, focused on individual needs. Several population groups have issues that require comprehensiveness as the basis of their healthcare strategies. For example, mental health, the health of indigenous populations, and women's health can be mentioned [19].

4.2) In the practice of general medicine, comprehensiveness also implies the understanding that the observer is an integral part of what they are observing. The approach focuses on collaboration (including our patients), the co-evolution of knowledge and health patterns, and a unified approach that does not reject objective analysis but recognizes its limitations [20]. 

3. To continue with the culinary analogies, if the "meatball" represents the holistic (where the ingredients merge into an inseparable whole) and the "Thali" represents the integral (where each part is in its place, contributing to a complete whole), the metaphor for the systemic would be "Risotto". Why is Risotto systemic? A) It exhibits dynamic interdependence: Unlike the Thali, where the separate ingredients do not affect each other, in risotto the starch in the rice, the broth, the wine, and the cheese constantly interact. If you change the temperature or the stirring speed, you alter the final result; B) There is feedback: The rice grain absorbs the broth and, in turn, releases starch that thickens the liquid. It is a circular exchange process, not a simple sum of ingredients; C) Emergent properties are present: The "creaminess" is not in the dry rice or the liquid broth separately; It arises from the chemical and physical interaction between them during the process; and D) It presents permeable boundaries: The flavor of the initial sofrito (the base) travels throughout the entire system by means of the fluid, connecting each grain of rice. Systems thinking is a comprehensive and (plus) holistic approach that analyzes the interconnected elements of a system to understand complexity, rather than studying the parts in isolation. It combines the overall view (holism) with the understanding of structure (comprehensive/integrated) and relationships, allowing us to see the whole and its interrelated components. The concept of integrality refers us to General Systems Theory. Systems thinking focuses on how the parts interact (relationships, feedback, structure) within a dynamic system. A systems approach is comprehensive and holistic: it is holistic because it sees the whole and it is comprehensive because it integrates all the parts and their interactions. For example, systemic coaching integrates all areas of a person (physical, mental, emotional) to understand them as a system, and provides the "network" structure to the integral approach. While the integral approach adds parts, the systemic and holistic approaches emphasize how those parts are interconnected and affect each other [21, 22].

In essence, systemic thinking is an approach focused on understanding how things are interconnected within a certain notion of a complete entity (23); Having a holistic and (plus) comprehensive view of the patient means considering the interrelationships of a person's various dimensions and seeing the whole as greater than the sum of its parts, as well as accepting integration, or the whole, as a given (23, 24) General Systems Theory applied to family medicine/general medicine posits that the elements of an organized set (e.g., family members, members of a group) are related to each other in such a way that affecting one element necessarily affects all the others. The healthcare professional-patient relationship is, in fact, triangular: GP-patient-family/context). GP is in contact with the patient for a few minutes, but the patient spends the rest of the time interacting with their family. Therefore, the family must be considered a fundamental element in treatment (hygiene measures, diet, medication, exercise, rest, etc.). GP also interact with the family: the degree of cooperation between GP and patient is related to the degree of cooperation between GP and family. The more complex the problem to be addressed, the greater the need to work with the family group. The family and the community are more than just a group of individuals, as they possess a set of stable interaction patterns that determine the behavior of their members. Conceiving of the family/community as a system helps to understand individual symptoms that may have a function within the group dynamic. The persistence of symptoms may indicate a difficulty on the part of the family in adapting to a particular situation of change or in resolving a specific conflict. Communication is the true vehicle of social interaction and, therefore, one of the essential concepts of social psychology and group dynamics. Communication is not a simple and linear process, but rather a complex and cyclical one. General Systems Theory studies the interrelationships between the components of a system and between systems and the suprasystem; therefore, it places special emphasis on communication: how the components of systems interact. Without communication, the units would remain isolated, and the system would not exist. A system can be defined as a network of communication relationships that has inherent circular properties. The results of relationships give rise to more relationships, thus amplifying the circular feedback loop. The closure of the network creates a system of shared beliefs, explanations, and values—a context of meanings—that is continuously sustained through further relationships [25]. In summary, using culinary metaphors to understand the concepts of holism, Comprehensive/integrated, and systemic, a glossary has been presented: 1) Holism ("The Meatball"): It is a fusion. The individual ingredients (meat, breadcrumbs, spices) lose their identity to form a higher entity. The flavor is the result of synergy. The whole is unity. You can't see where the meat ends and the breadcrumbs begin; the flavor is total fusion.

2) Wholeness ("Thali"): It is a complete collection. Each element is distinct and perfect in its place, and the value lies in the fact that the offering is so broad that no gap is left unfilled. Completeness. You have protein, carbohydrate, vegetables, and fruit; everything is present and organized, but each element maintains its separate physical identity. While the holistic approach focuses on the essence of the whole and its interactions, the integral approach ensures that all pieces of the puzzle are present so that nothing is missing. And 3) Systemic ("The Risotto"): The relationship. The parts are distinguishable (you can see the grain of rice), but their state and flavor depend entirely on their active and constant interaction with the other ingredients.