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"Lisa Steen: The wilderness of the medically unexplained" - GP with cancer misdiagnosed as psych.

Discussion in 'Other Health News and Research' started by Kyla, Aug 25, 2016.

  1. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    http://blogs.bmj.com/bmj/2016/08/25/lisa-steen-the-wilderness-of-the-medically-unexplained/

    excerpt:
     
  2. AndyPR

    AndyPR Senior Member

    And if she had that experience, what are the chances of us mere mortals getting decent treatment. :mad:
     
  3. PennyIA

    PennyIA Senior Member

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    I have heard repeatedly that 'something' was impossible, when in fact, it was rare.

    In my lifetime, I've experienced 4 medical things that were previously deemed 'impossible' to me or too rare to bother testing me for it, but found after escalating and pushing doctors pushed to do their jobs.

    1) at six they found a pocket of skin in my throat (I was six, I'm sure there was a medical term for it, but this is how it was explained to me) (1 out of 200,000 chance)
    2) Protein C Deficiency (occurs less than .02% of population) causing blood clots
    3) B6 toxicity on 50 mg per day of B6 (no idea, I honestly think this is underdiagnosed because doctors don't test for it until you force them to)
    4) My cervix & ovaries were left in after my hysterectomy - and they've decided that the cervix can grow an endometrial lining and function as a miniature uterus (not sufficient to carry a baby to term, but in fact, dangerous because I can have an ectopic pregnancy now post-hysterectomy).(like 1 in a million shot here)

    It's great that doctors were given the analogy of 'when you hear hoofbeats, it's probably a horse and not to go looking for a zebra'... BUT what they are missing is that when the treatment doesn't work and you don't know what it is? NOW you start looking for zebras. They may be rare, but you can't rationalize rare as being non-existent.

    Oh, and stats for this? Came from doctors who were 'astonished' (and quite pleased with themselves) when they found the items or discussed it later in life.
     
  4. sarah darwins

    sarah darwins I told you I was ill

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    Even with less rare conditions, it seems to me the lesson of this tragic story is that the psychologized conception of MUS is quite unlike any other misdiagnosis.

    If a doctor thinks you have a heart problem when in fact it's your liver, chances are that doctor is eventually going to realise their mistake during attempts at treatment.

    But if a doctor thinks you have a somatisation disorder, they're probably never going to change their mind — anything that happens with you can be conveniently 'explained' by your psychological disorder.

    That's what's so damned pernicious about the whole MUS/somatisation thing. Once you're filed in that category, the doctor who put you there is never going to let you out, except perhaps at autopsy.
     
  5. Esther12

    Esther12 Senior Member

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    Kind of her to write the blog.
     
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  6. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    I'm not sure what the author's original intention for this piece of writing was, but it looks like it was actually published posthumously by her husband.
     
  7. alex3619

    alex3619 Senior Member

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    I am reasonably sure this is the second thread on this, the first one dating back several years. These kinds of things occur far too often.

    If doctors would only treat the unexplained as unexplained, or not yet understood, or something similar, instead of trying to force misleading labels on things, then I think things would be much better. Claims to psychogenic illness much more resemble a cultish religion than science. Its become a convenient too hard basket.

    That doesn't just mean too hard for the doctor, its also about it being too costly for those paying the bills. Its a false saving to sideline patients though, the secondary consequences probably cost society far more. To be clear, its a false saving to society, but it can look good on a minister's report, or to the CEO of an insurance company. Its another case of passing the cost onto the rest of society. Its a case of denial being profitable.
     
  8. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    I don't think it could be the same article as this one was published today. And she talks about getting her diagnosis in 2014.

    Doesn't surprise me that there have been similar stories published
     
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  9. GreyOwl

    GreyOwl Dx: strong belief system, avoidance, hypervigilant

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    I thought it was a tragic story and a powerful article. There was one part that didn't sit right with me:
    I just do not believe that is true.
     
  10. Richard7

    Richard7 Senior Member

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    I have to agree: there are lots of workplaces that expect people to work too hard; there are lots of workplaces that treat those dealing with chronic illness, particularly mental illness, poorly; most people earn less money and have no chance of going private; and the vast majority lack the expertise to try to work out what is wrong.

    Having said that: people should not be working themselves into the grave, etc etc and her story of course is terrible. The problems she notes exist, she is just wrong in thinking them peculiar to her profession, though I imagine that idea might be one that the doctor's reading the article can get behind..
     
  11. alex3619

    alex3619 Senior Member

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    Yes, you are right, I was recalling a very similar story.
     
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  12. Valentijn

    Valentijn Senior Member

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    Oh, I think there's plenty who would still be claiming there was also a psychosomatic factor, especially at the autopsy. They've contributed to the death of a patient, and they need to find a way to justify that. It's been my observation that ones who will propose and believe a psychosomatic disorder are not much into self-reflection or examining their own errors.
     
  13. garcia

    garcia Aristocrat Extraordinaire

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    I love the way they turn the story into how tragic the situation is for doctors, rather than how tragic the situation is for patients! The fact she was a doctor seems to have blinded her to the fact that patients are treated this badly (and die as a result) all the time. It's normal for us. Only when patients aren't doctors they don't get to have posthumous blog articles published in the BMJ, because the BMJ only cares about doctors not patients.

    Let me just take one paragraph:

    >"The communication was different, it didn’t go the same way that it would have if I was a non-medic."
    Really? So doctors treat other doctors worse than they treat lay-people? I find that very difficult to believe.

    >"Doctors do not like being told what to do, and if you try obliquely they don’t notice."
    This it true, but doubly so when the person doing the telling doesn't have a bit of paper certifying that they wasted 7 years of their life in medical school memorizing as many unrelated factoids as possible so they can pass the next exam.
     
  14. Richard7

    Richard7 Senior Member

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    @Valentijn something about your comment reminds me of the dead parrot sketch.
    shes not dead she's probably just pining for the fjords
     
  15. sarah darwins

    sarah darwins I told you I was ill

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    I did say 'perhaps'!
     
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  16. justy

    justy Donate Advocate Demonstrate

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    Hello - not seen you around in a long time! I totally agree with your analyses of this.

    Most of this story sounds very similar to what I have experienced. I still, like most of us here, have no idea if I have something very rare or even life threatening - No GP makes any effort at all once you have anxiety on your notes...
     
  17. Dolphin

    Dolphin Senior Member

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    Looks like the CBT didn't help her.

    Also

     
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  18. Dolphin

    Dolphin Senior Member

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  19. Dolphin

    Dolphin Senior Member

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  20. Dolphin

    Dolphin Senior Member

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