DEAR DR. GOTT: Please address this all-too-common problem among doctors. The doctors treating the woman who wrote some time ago, didn’t know what she had, therefore, they concluded (defensively) that she had nothing wrong with her, therefore, it must be mental. This outrages me! I had a son who died from myalgic encephalomyelitis (ME/CFS), and all those patients hear is “It’s in your head” because at this time there is no definitive marker and no drug approved by the FDA to help them. Not knowing is not the same as nothing is wrong.
I would also suggest that your advice is too accepting of “nothing can be done”. Wow! Something happened to that lady. Most of the people in the US are not able to get to the Mayo or Cleveland Clinics. Your usual advice to get to a teaching hospital is much more “doable”.
I read your column faithfully and frequently forward your articles. You LISTEN to your readers and do no generally accept as gospel the dogma of the medical profession. (I am not a doctor hater, just a doctor skeptic, for self-preservation purposes.)
DEAR READER: There is a general thought that if a cause cannot be found within a reasonable amount of time, that it may be psychiatric in nature. This isn’t just a failing of doctors, but society. In some cases, a psychiatric cause is truly the culprit, but in others it may be the result of a little known, unknown or poorly understood condition that is extremely difficult to diagnose.
Unfortunately, in these instances, until the cause is found and understood, there is little to nothing that can be done. Physicians may recommend trying various medications, therapies, even surgeries (depending on the symptoms, etc.) but these are essentially guesses.
Medicine is still evolving. We don’t have the answers for every ailment that humans can suffer. It can take years to just to realize that a certain group of symptoms are related to a single cause. It can take still more time to figure out what the cause is, and still even more time researching and experimenting on potential treatments.
So while, not what anyone wants to hear, doctors are still human. Sometimes we make mistakes and sometimes we simply don’t have the answers. That, however, doesn’t excuse us from giving up when a patient needs help, despite repeated attempts to find the cause. In my experience, if a physician is up-front and honest about not knowing the answer but is willing to stand by and work with the patient, it can go a long way in making the patient feel better about the situation, despite no immediate answer. This extended relationship can also help both patient and doctor to relay information and narrow down potential diagnoses, necessary testing and even treatment options.
