love your scenario....so this is tied into how they assume if your well informed ab out your possible illness, you must be a hypchondriac?
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The short answer is Yes; the long answer there could be other resoutions besides hypochondria to the schema violation, but hypochondria is a pretty convenient resolution from their pont of view if you think about ti.
So the schema/script calls for one medico, who is the expert and one patient who is the grunt. Script says grunt enters asks for help from the expert, expert "solves" problem, everyone leaves happy. Expert is reassured of his expertise which feels good, patient no longer has complaint, which feels good. So it's the old patient saying "it hurts when i do this" Doctor: "So don't do that". Script over. Next episode.
NOw consider what we do. Medico comes in. Instead of "it hurts when I do this", we say "Ok, what I've figure out so far is that factors 1, 2, 3,...to 14 are not relevent (hands medico a 3 page summary) and was able to rule those out through experimentation, lab tests, etc but I'm stuck and really need help with factors 15 and 16. Can I try maybe a trial of X to test out 15? How about a blood test for Y- I've never had that and it may show item 16. Also I'm not clear on how the mechanism works by which...do you by any chance understand how ATP is generated when...."
Medico blinks 3 times rapidly in puzzlement. This wasn't in the script! It's like Romeo would be stunned if suddenly Juliet starts talking about sheep in the pasture and what she did on her summer vacation rather than professing undying love. What to do? Romeo might go on with his prepared lines, ignore the glitch, the play goes on, maybe all will just forget the hiccup.
So the medico tries at first to do just that: "I've seen the thyroid produce alot of strange symptoms. I'll test for TSH, that stands for thyroid stimulating hormone (grunt rolls eyes) and come back in 6 weeks..." . Grunt can barely contain fustration and tries as calmly as possible: no, thyroid was item 2 - it's there in the paper I just gave you. It was one of the first things I considered. Every year at least I make sure to test. My high sensitive TSH is normal. It's also identical to the value it's been for years before I got theses symptoms. I also had tested T3, T4, reverse T3, T7 and since I know autoantibodies to thyroid can be present years before symptomrs, just in case those were there so I had anti thyroglobulin and 2 others anti-thyroid antibodies tested. I know there's still in pricinicple 2 more of those I could check but the odds are too low". (sounds like us, right??) I really I don't want to start all the way back at square 1; i'm not getting anywhere. How about trying the med...
Now medico knows the first script violation was not a glitch and he can't go on with his lines as planned. So now what? One possiblity is to throw out the script. Say ok, i'm in a different tv show. in this one, there's not 1 expert but 2 experts (and man that 2nd one I have to admit is more up to date on this than I am) and if he/she says theyve ruled out the first 14 possiblities, ok, let's start at 15 A couple do this resolution but most don't. it requires having no script and having to "wing it".
So waht the is the resolution if not that. Medico thinks: hmm what would make a non expert grunt spout that level of detail and act like an expert- I know! we learned in med school hypochondriacs go that! Now he can go back to the script. his help is to let you know that's what you have.
when i said before when the nurse has to "put you back in your place" i think that's thre right way to describe what often happens here. (and with nurses there's a further wrinkle- theyre between docs and patients. docs are above them, patients are below them. Theyll be damned if a patient ever tries to get above them! its bad enough docs are.) Obviously not all act this way. but it fits with many times. the more grunt tries to show the medico interpration is wrong, the harder the medico has to dig in the heels, be in doc or nurse phlebotomist even to try to put grunt back into his/her place, to make sure they follow the script. Me trained expert, you grunt who lacks expertise,
Every now and then, someone will approach me by email in my area of expertise, and instead of briefly saying "can you tell me about x" or "can you help me with x" etc. , I get a monologue in which they are telling me everything they learned and discovered through their often extenwsive layman research Sometimes at the end, theyll ask if i have comments on the monologue. other times they forget to add to it a queston. Either way, I have to say, it's a turnoff- even knowing what i know about being in the other role. And usually despite normally being very helpful, I rarely can help such folk.
no moral here, it's just how it works out given our circumstances.
