Sunday, January 23, 2005

"What's amazing is not the medical error rate..."

More from the patient who responded to "Worried Sick." He was diagnosed with hypochondria, with symptoms so severe and intractable that his engineering job was affected. Later he was found to have intermittent atrial fibrillation and migraines. I had called him "amazingly magnanimous," because even after his ordeal, he seemed so free of rancor. Here's his comment:

I don't know if "amazingly magnanimous" is the right description for me. More like "amazingly tired of worrying." Living in the past so I can keep worrying about random bad luck just doesn't hold much attraction to me.

Also, as an electrical engineer I have spent days at a stretch figuring out what's wrong with a simple circuit. And that's a deterministic system, not the hundred trillion cells and few hundred thousand genes in a human! What is amazing is not the medical error rate that the media loves to flog, but the success rate. Especially the success rate for things that are almost invisible to objective testing, like your specialty.

I agree - it is amazing when we succeed. Patterns of illness are revealed when something goes wrong wih those cells and genes. But those patterns can be elusive. For every patient like this engineer, there are many more who never receive a strictly medical diagnosis. They are often referred to psychiatrists.

These patients are often miserable. Their distress can take on the quality of an independent problem. Further testing may or may not reveal a medical cause. How to cope with that uncertainty? How to get through today? That becomes the focus of treatment.
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