I have really enjoyed reading Groopman’s book. I really related to some of the points he made in the book and many of his stories brought up my own life experiences. Reading the quote:
“A wealth of research shows that patients thought to have a psychological disorder get short shrift from internists and surgeons and gynecologists. As a result, their physical maladies are often never diagnoses or the diagnosis is delayed.” (39)
Made me think of a number of cases I am familiar with. One such case is of a friend of mine and although not directly a case of a psychological disorder, it still follows the same principle. When she was younger, her parents were going through a divorce and it was very difficult on everyone. She began to suffer from excruciating (lower) back pain and would complain about it. They took her to be checked out more than once. The doctors repeatedly (without doing a full MRI) decided that it was psychosomatic pain and/or she was faking it for attention. She had a tumor the size of a grapefruit in her spine which they finally discovered when she became paralyzed from the waist down. Pain, especially vague symptoms of pain are often taken less seriously than visible symptoms. The only symptom is patient reported and they cannot verify that symptom. So unless they find the cause, they cannot verify whether or not it is psychosomatic.
Groopman late states:
“These days, when we are not getting better, most of us return to see the doctor with ideas about what might be wrong. Our notions sometimes come from knowing a friend or relative with a similar symptom, or ideas may have been sparked by looking on the Internet. Our thoughts about our unrelieved symptoms often focus on the worst-case scenario.” (261)
Just like this quote of Groopman’s, when I began experiencing excruciating lower back pain this past summer I kept in mind the case of my friend. In my case, it began with leg pain/numbness and other symptoms, but then spread to unbearable lower back pain. Lower back pain is a fairly common symptom and is often due to “”strain” or “sprain” in the lumbar region” (226) and “90 percent improve within two to seven weeks without specific therapy”(226). However, my mind jumped to the “worst-case scenario”(261) of what if it didn’t go away on its own. What if it were like the case of my friend and it only got worse? I tried to wait it out and see if it would get better. Instead, it got slowly (and then more rapidly) worse. I scheduled an appointment to see my doctor*.
I found it interesting that Groopman learned that, “doctors desperately need patients and their families and friends to help them think. Without their help, physicians are denied key clues to what is really wrong. I learned this not as a doctor but when I was sick, when I was the patient.” (7-8). The idea that you can learn more as a patient than as a doctor I find interesting. The amount of information that my doctors would miss if I didn’t understand my medical history as well as I do is baffling. Without my mother’s probing questions at a consult for a tonsillectomy, I wouldn’t have been sent for a hematology work-up. My ENT refused to operate on me without it, which is good, because I could have bled out during the surgery without the proper medication beforehand. Being a smart patient and having smart medical minded parents has saved my organs and probably my life more than once.
(*If anyone is interested in what happened when I saw the doctor for my back, feel free to ask me via email or in class. I wound up having to have neurosurgery on my spinal cord and I have found the entire experience highly educational and fascinating. I do not mind discussing my medical oddities with people who plan to pursue medicine and might learn something from them.)
Physical and Psychological illness/ diseases and how they intermingle or coexist can be pretty tricky. It's horrible that it would take a tumor swelling to the size of a grape fruit in order for a child's pain to be taken seriously. But when so many cases of physical pain or ailments follow emotional trauma, it makes sense that doctors would first try to eliminate psychological factors as being the root. We have even read about how emotional and psychological trauma can result in stunted growth (Peter Pan Syndrome). So when an ache or pain occurs in the midst of an emotional trauma, it seems logical a doctor might suspect the trauma is a cause of the physical illness.
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