Posts Tagged ‘Medicine’s parallel universe’

Disease was once thought to be due to sin. We now know more,  but not enough.

Edited and reprinted from a prior edition of Blogfinger.

By Paul Goldfinger, MD, FACC

Most people have high hopes when they go to a doctor with a problem.  They want to believe that their physician will do some tests, find out what’s wrong, and then fix the situation. That is usually what happens. However, doctors sometimes do not recognize their own limitations. They may not  like to admit to themselves or to  patients that they do not know what’s wrong and what to do. The fact is that there is much that doctors do not know and there is much that they do which is unproven.

Sometimes a physician will suggest a second opinion. That is always a good idea, but the patient should go to someone who is a known authority in the field, even if it means a trip into New York or Philadelphia. Seeing a real expert may help put a halt to the doctor-shopping.  But what happens when no doctor knows the answer no matter how many you consult?  What happens when a situation hits the wall of the unknown?

There is a parallel universe where people reside with persistent symptoms despite the best efforts of doctors.  I know someone who has chronic vertigo. He has seen multiple specialists in New York City and has had every possible test for this condition. No diagnosis or effective  treatment has been found. The patient is still dizzy; he has been seen by professors without answers as well as charlatans who waste his time and money. He makes the best of it, but he keeps looking for another doctor who might help. He scours the internet for solutions.

Most everybody has something physical that bothers them, and if there is no definite diagnosis,  they try to get by, one way or another.   Some get conventional care from their doctors, while others resort to alternative therapies and OTC medications.  Many simply accept their fate and lead their lives without further tinkering by the medical establishment. But the ones who keep bouncing around from doctor to doctor, without diagnostic or therapeutic success,  are the ones who need the most guidance from the medical profession.

Physicians sometimes need to stop the snowballing of tests and opinions. Stopping means to admit that the patient’s problem cannot be solved, so the doctor needs to shift gears and focus on attentive and supportive symptom relief. It’s difficult to judge when that time has come. It has to be a decision made by the doctor and his patient. But once the decision is made, the physician  should continue to follow the patient, because you never know when an answer might appear.

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