An Anatomy of Chairs

By CLIFTON MEADOR, MD   R had been my patient for over a year. She was referred to me by a colleague. She had 38 symptoms. All tests and imaging studies failed to find any demonstrable medical disease; I considered her to have “symptoms of unknown origin”. I had little information on R’s personal and family history. I did know she was 43 years old and was 7 years into her second marriage. Her first marriage ended in divorce from a severe alcoholic husband. She had no children. She dwelled on her many symptoms and avoided all my attempts to gather more personal or social information. Before I can share my full experience with R, I need to provide some back ground on my clinical thinking. Over my fifty years in medical practice, I became fascinated by patients who had physical symptoms in the body but no definable medical disease.  Many doctors did not like or enjoy such patients and were glad to refer them to me. Some labeled these patients as hypochondriacs, or worse, with pejorative terms such as “crocks” or “turkeys”. I think their frustration with failure to help these patients was the source of their disdain. Early in my experience with these fascinating patients, I kept asking myself the  question, “If these patients with symptoms in the body do not have a medical disease, then what do they have? What is the cause of their symptoms?” My guiding principle became, “There is not a medical disease behind every symptom but there is a cause if on...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: THCB Symptoms of Unknown Origin Source Type: blogs