Sunday, April 26, 2009

Good Advice for Patients – and Their Doctors

Dr. Alex Lickerman, the proprietor of Happiness in this World, just put up a thoughtful, masterfully written post, When Doctors Don’t Know What’s Wrong. While it's primarily directed toward patients, I'd encourage all physicians and veterinarians to read it, too. Here's the beginning:
The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one: he had headaches. The reason I remember he had headaches isn’t because I spent so much time discussing them but rather the exact opposite: at the time I knew next to nothing about headaches and somehow managed to end the visit without ever addressing his at all, even though they were the primary reason he’d come to see me.

Then I rotated on a neurology service and actually learned quite a lot about headaches. Then when my patient came back to see me a few months later, I distinctly remember at that point not only being interested in his headaches but actually being excited to discuss them.

I often find myself thinking back to that experience when I’m confronted with a patient who has a complaint I can’t figure out, and I thought it would be useful to describe the various reactions doctors have in general to patients when they can’t figure out what’s wrong, why they have them, and what you can do as a patient to improve your chances in such situations of getting good care.

Not only should you read all of it, you should share it with as many people as you can – especially your doctor and your veterinarian.


  1. That was horrifically too long. For the layman one needs to get it into a few laconic 'graphs. My issue was a face that could no longer wear glasses . . . Had to turn to contacts, which I despise. All the doctors and others I consulted didn't believe me.

  2. Waiting for approval removes the impulse to keep on keeping on. I suggest you just let it fall where it may and then remove later if so desired. So tired.

  3. Sissy, Thanks so much for stopping by and taking the time to comment. I am honored.

    I have taken your advice and opened up comments to anyone who registers or has an Open ID; even turned off the captcha.

    About Alex's essay, though -- your comment reminds me of the scene in the movie Amadeus in which Emperor Franz Joseph tells the young Mozart that his opera The Abduction from the Seraglio contains "too many notes." Mozart replies that "There are just as many notes, Majesty, as are required. No more; no less." That's how I regard his essay -- there are just as many words as are required, and I wouldn't change a single one. But on the other hand, I read it from the perspective of a diagnostician as well as a patient. Therefore I understand both sides.

  4. Morton: Thanks for opening up the comments. I think it will be good for you and your readers.

    As for too many notes, the Mozart analogy is superb, although when it comes to words, I have always been of the less-is-more school. Am enjoying that aspect of Twitter in that tweets are limited to 140 words . . . As I twittered to one of my friends out there, "Like sonnets and haiku, it focuses the mind."