Do Gods in White Exist?

[SWAlexander]

In my 76 years of life, I’ve only been fortunate—twice—to meet doctors who went beyond the standard 10-minute visit before handing me a prescription.

Most recently, I faced yet another disheartening experience with a primary care physician. Like many before him, he seemed to believe that reviewing my extensive medical history—including a previous episode of sepsis—was unnecessary. Instead, he focused narrowly on a blood pressure reading of 179 taken a month prior, while entirely overlooking the visible symptoms of Stevens-Johnson Syndrome (SJS). My skin was peeling extensively, especially on my legs, yet he simply prescribed a 12% Urea Carbamid cream and dismissed any further investigation.

This was despite my known diagnosis of adrenal insufficiency and the possible link to aldosteronism—both relevant, both ignored.

At the follow-up visit, I told him my symptoms had worsened, but he brushed aside my concerns again. A month later, I asked if he could perform a swab test for Penicillium after I showed him photos of fungal growth in a petri dish where I’d planted salvia. He questioned the legitimacy of the photos, so I presented the actual petri dish. I explained that the same type of growth could be linked to chronic discharge from my unusually deep navel—possibly tied to a Urachus Diverticulum.

I suggested that a urine test might be appropriate, as there’s evidence that such infections can show up in urinalysis. His response?

“There’s no such thing.”

Instead, he wrote another prescription—this time for VOBADERM cream—and again refused to order a urine test.

Could medical neglect and lack of knowledge be the reason why many people suffer lifelong illness, despite the fact that simple diagnostic tests might have prevented long-term complications?

 

[southwestforests]

Could medical neglect and lack of knowledge be the reason why many people suffer lifelong illness, despite the fact that simple diagnostic tests might have prevented long-term complications?

Yes. Totally. Absolutely.

Things which now come to mind:

And a large part of the blame for that can be laid here;

When you hear hoofbeats look for horses not zebras.

Reference: https://quoteinvestigator.com/2017/11/26/zebras/

And this concept is directly relevant;

but most zebras arrive with their diagnosis already made, in search of care.

Rewards of zebra care​

Most of my zebras have been wonderful patients; they are very grateful for an inquisitive approach and receiving knowledgeable attention rather than being dismissed as having problems beyond the interest of a mere general practitioner. Once we understand the problems and needs of these patients, they are relieved that they can relate to someone who engages to work consistently with them, even though there is no cure. Then they can stop searching vainly for help from physicians who focus only on their specific disease or only one part of it.

Treating zebras engages the brain, as you work out how to distinguish the unusual features of the disease from the other medical problems that life brings these people. When meeting a zebra, having a sense of curiosity and interest with willingness to search and learn leads to new insights and personal rewards. After the initial effort of learning the issues for this particular one, it is easy to follow along. If they die or move elsewhere, we might never see their particular species again in our practising life, but as other representatives of the genus Equus appear we will require new learning. Most hoofbeats do indeed arise from horses, but when zebras turn up, they require equine care that is adapted to their specifics.

From:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4982713/

 

[pamojja]

In my 76 years of life, I’ve only been fortunate—twice—to meet doctors who went beyond the standard 10-minute visit before handing me a prescription.
....
Could medical neglect and lack of knowledge be the reason why many people suffer lifelong illness, despite the fact that simple diagnostic tests might have prevented long-term complications?

Ignorance and lack of real interests abounds in the medical profession. So yes, that is a reason for worsening of chronic illnesses.

On the search for a medical professional with more interest, I too found 2. Expecting at least some guidance. However, turned out completely unexpected, after going through decades of medical history and employed strategies against. They both, one internist with chiropractic and orthomolecular medicine additional education and experience, and one very old and locally deeply respected Ayurvedic practitioners, couldn't give me further guidance, other than encouraging: they, in my situation, would do exactly as I did!

The internist, at least, was so sincere, not to charge me for the 2 hrs consultation. Because had learned himself a lot thereby, he explained. The Ayurvedic costs 1,- only (local price). But surprised my insisting, that I use Ayurveda rather ignorantly. Where usually the individual dispositions, wind, fire and phlegm (Vata, Pitta, and Kapha) should always be kept in mind for treatments. He informed my dispositions aren't really out of balance, but only in a minor way between between the subfractions of upward and downward moving vata.

At that time I had found a GP, who at least tried to order most lab-tests. And those he didn't I had to pay out of my own pocket, for which he gave me the in such cases needed signature of an MD.

Could medical neglect and lack of knowledge be the reason why many people suffer lifelong illness,

So without a guiding but following GP (usually with just 1-2 minutes for each of his many patients), in my case remissions of PAD, COPD and PEMs were possible. Beside disinterested MDs, also lack of one's own investigation and self-education, self-reliance, with trial and error, while monitoring with, if needed self-paid, lab-tests, could be further factors hindering recovery.

And in an unexpected turn of event, those further factors exactly came into effect, also especially because of the ignorance in MDs.

 

[SWAlexander]

Yes. Totally. Absolutely.

Things which now come to mind:

And a large part of the blame for that can be laid here;

Reference: https://quoteinvestigator.com/2017/11/26/zebras/

And this concept is directly relevant;



From:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4982713/

Thank you for the zebras.
I’ve regretted moving back to Germany in 2019—many times. In the U.S., we often criticize the healthcare system, and rightly so. But what is the value of universal healthcare when so many doctors here seem stuck in the 1950s? In my experience, few keep up with current medical research or read scientific literature at all.

Back in 1984 in Germany, I suffered from persistent, severe headaches and neck pain. I visited multiple primary care physicians, each prescribing different pain medications without investigating the root cause. During a follow-up for a cancer-related appointment, I mentioned my worsening headaches to my gynecologist, who referred me to a local neurologist.

The neurologist’s evaluation was brief and dismissive. He remarked that “most women have headaches,” lightly pressed on my temporal lobes and the back of my skull, and asked what I felt. I said I felt pressure. His conclusion? “You’re just neurotic. Go home and take some aspirin.”

It wasn’t until 23 years later, in the U.S., that an MRI finally revealed what had been missed all along: Chiari malformation type I, Ankylosing Spondylitis, spinal stenosis in L4 and L5, and Tarlov cysts.

These weren’t just “headaches.” They were symptoms of serious, diagnosable conditions that had been overlooked for decades.

 

[SWAlexander]

At that time I had found a GP, who at least tried to order most lab-tests.

Every now and then, we get lucky. In 2007, I was fortunate to find an endocrinologist in Albuquerque who believed that truly understanding a patient meant taking the time to listen. He spent a full hour going over my medical history and recognized a diagnosis that had been missed since 1979: Adrenal Insufficiency.

 

[southwestforests]

It wasn’t until 23 years later, in the U.S., that an MRI finally revealed what had been missed all along: Chiari malformation type I, Ankylosing Spondylitis, spinal stenosis in L4 and L5, and Tarlov cysts.

Ohhh, that's quite a collection.

In 2009-2015 when I was on Facebook and in a few CFS and Fibromyalgia support groups there were 3 or 4 people with Chiari, and couple of them, including a 20-something gal named Elyse, had had so many surgeries they nicknamed themselves 'zipperheads', which seems to be a thing in the chiari community. College age is a tough time for a person to be disabled by anything.

Ankylosing Spondylitis is kinda fun to say but rather un-fun to have. A friend in India, made on Google Plus while it was a thing, has that. https://manicsylph.com/

 

[SWAlexander]

'zipperheads'

Yes, that's me:

 

[southwestforests]

That brings to mind a saying heard somewhere,
"Livin' la vida medical trauma"

 

[SWAlexander]

"Livin' la vida medical trauma"

Including the years of neglect and insults from some medical professionals.

 

[Rufous McKinney]

My doctor had some God-like qualities. And I only found him by total accident. I had to change insurers and could not continue to see the incompetent doctor team here in my small town. I wasted ten years there.

Across the parking lot, that whole time, was the Wonderful Doctor. Not perfect, but close.

Fifty minute appointments, and often you can see him the same day. I never waited. And he refused to speak to Pharma Representatives.

Knew all about ME.

Knew all about Stanford.

Gave me an SEID diagnosis after the first 45 minutes.

Got me on LDN.

Provided critically important Moral Support.

My doctor was locally known for getting older people off of excessive medications other doctors and the nursing care places, give these people.

- WHEN are doctors provided the time called: Research and Investigate Mysterious illness in Patients X, Y and Z?

Something about ALL THAT is a key problem.

My doctor spent his evenings writing books on his cardiac theories, drinking a bit of wine and chatting with his fiancé, who resided in a foreign country. He's busy. (in this example, are doctors doing this research at home after all those office hours)?

I think doctors cannot bill for researching and investigating an illness. and THAT might be the key problem or a spot that needs ATTENTION and FIXING.

 

[SWAlexander]

Wonderful Doctor

Yes, there are good and caring doctors out there.
But then, there are also those who see patients merely as paying customers.

I remember one doctor once told me that simply reading medical research for 15 minutes, three times a week—just the introduction and results—could help avoid major errors.

 

[Zebra]

Could medical neglect and lack of knowledge be the reason why many people suffer lifelong illness, despite the fact that simple diagnostic tests might have prevented long-term complications?

A big fat YES!

There are so many systemic reasons why primary care physicians (or general practitioners) cannot provide even the standard level of care.

And, there are so many different kinds of personal short-comings, or personal failings, in these human beings who put on white coats every morning and do, or do not, provide adequate care to their patients.

It's rough out there in the medical system, and it's only going to get worse as fewer medical students desire to become primary care physicians/general practitioners.

 

[bad1080]

if you mean gods as in "too far removed to care about human suffering" then yes, they exist.

 

[SWAlexander]

the medical system, and it's only going to get worse as fewer medical students desire to become primary care physicians/general practitioners.

How true.
In Germany, over 5,000 primary care physicians have left the profession since the COVID-19 pandemic. For years, policymakers have ignored the increasing strain on general practitioners, gradually undermining their role by limiting their ability to order diagnostic tests or conduct thorough examinations.

Meanwhile, many patients have become passively compliant—rarely questioning treatments, even when they are inappropriate or ineffective.

Just a few weeks ago, the young daughter of a primary care physician told me she plans to pursue a medical specialty instead of general practice—simply because it offers better pay and more recognition.

 

[southwestforests]

Just a few weeks ago, the young daughter of a primary care physician told me she plans to pursue a medical specialty instead of general practice—simply because it offers better pay and more recognition.

It's rough out there in the medical system, and it's only going to get worse as fewer medical students desire to become primary care physicians/general practitioners.

You know me, I like to give references,

Shortage of primary care doctors in U.S. comes down to money — and respect​

By Felice J. Freyer
Updated on: January 9, 2025 / 11:34 AM EST / KFF Health News

https://www.cbsnews.com/news/shortage-primary-care-doctors-money/

Primary care typically gets little respect. Professors and peers alike admonish students: If you're so smart, why would you choose primary care? Anand Chukka, 27, said he has heard that refrain regularly throughout his years as a student at Harvard Medical School. Even his parents, both Ph.D. scientists, wondered if he was wasting his education by pursuing primary care.

Seemingly minor issues can influence students' decisions, Chukka said. He recalls envying the students on hospital rotations who routinely were served lunch, while those in primary care settings had to fetch their own.

Despite such headwinds, Chukka, now in his final year, remains enthusiastic about primary care. He has long wanted to care for poor and other underserved people, and a one-year clerkship at a community practice serving low-income patients reinforced that plan.

When students look to the future, especially if they haven't had such exposure, primary care can seem grim, burdened with time-consuming administrative tasks, such as seeking prior authorizations from insurers and grappling with electronic medical records.

While specialists may also face bureaucracy, primary care practices have it much worse: They have more patients and less money to hire help amid burgeoning paperwork requirements, said Caroline Richardson, chair of family medicine at Brown University's Warren Alpert Medical School.

"It's not the medical schools that are the problem; it's the job," Richardson said. "The job is too toxic."

Gen Z doctor shortage​

America needs 90,000 more family physicians. Med students have different priorities.
Manisha Krishnan
Mar 20, 2025, 3:22 AM CT

https://www.businessinsider.com/gen...-students-primary-care-family-medicine-2025-3

But each year, hundreds of medical residencies for primary care programs struggle to find students, and many who enter the field end up abandoning it. Across the medical field, people look down on primary care work — which includes family medicine, internal medicine, pediatrics, OB-GYNs, and geriatrics — because it doesn't pay as well, is an administrative slog, and isn't considered as prestigious as other specialties. There's even a term for the bad-mouthing of primary care: specialty disrespect. Georgetown notes a study that found it could affect up to 80% of students, particularly those considering going into primary care.

That's leaving Americans without enough doctors to go around.

Specialty disrespect was defined by one study as "unwarranted, negative, denigrating, even sarcastic comments made by trainees and physicians about different specialties." It surveyed med students at the University of Washington School of Medicine between 2008 and 2012, and 87.7% of students who matched into family medicine residencies said they had experienced specialty disrespect — a higher percentage than for any other specialty — compared with just under 80% of all respondents. About one-quarter of respondents said the comments had a moderate to strong impact on their choice.

 

[SWAlexander]

What’s restricting (PCPs)?
Is it politics, insurance companies, or something else?
Where does the real problem lie?

 

[southwestforests]

Where does the real problem lie?

It lies within basic human nature.
Which probably feels like a not-actually-an-answer generalization.
Even so, pride, self interest, selfishness, arrogance, and such, are what seem to be at the foundation of the thing.

 

[SWAlexander]

pride, self interest, selfishness, arrogance,

I agree. These are the basics of the MAOA gene.

 

[pamojja]

MAOA gene

From the Buddhist perspective, we know of the Avidyā. ignorance, link in dependent origination:

"Not knowing suffering, not knowing the origination of suffering, not knowing the cessation of suffering, not knowing the way of practice leading to the cessation of suffering: This is called ignorance. It leads to action, or constructing activities."

While activities, Saṃskāra, as those mentioned already, are already downstream effects. Similar as seen with the MAOA gene.

pride, self interest, selfishness, arrogance, and such,

 

[SWAlexander]

From the Buddhist perspective, we know of the Avidyā. ignorance, link in dependent origination:


While activities, Saṃskāra, as those mentioned already, are already downstream effects. Similar as seen with the MAOA gene.

Regardless of the perspective, the manifestation of MAOA is rooted in neurological evidence. Anyone who encounters a person with this condition is likely to experience harm in one way or another.

The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain by James H. Fallon​