One of my colleagues has always felt cold hands and feet since the beginning of last winter. At first he thought it was the heating problem. But soon he changed his office and moved to another building. The problem remained the same, which made him suspicious of himself. He searched the Internet and found that if the blood vessels contracted, there would be such a phenomenon. So he went to a doctor. As a result, everything was normal after some examination.
The doctor finally told him that he might be getting old, so go home and put on more clothes. My friend was naturally not satisfied with this unclear explanation in the back row, but he could only go home doubtfully. Sickness is defined by human beings! Feel uncomfortable, Feeling sick, Naturally, I want to see a doctor. Even if the doctor doesn’t have to treat me, But at least be professional, Let’s make a definite diagnosis. Well, It is the mentality of most people to see doctors. However, Sick this thing, In fact, it is defined by human beings. For doctors, All kinds of things that can be said and felt, It’s a symptom, And the name of the disease is just an invented word, It is our generalized summary of certain specific symptom combinations. The problem is, In real life, There are a lot of situations, Despite the symptoms, But it is very difficult to diagnose. This kind of situation, The scientific name is “medically unexplained physical symptoms”, MUPS), In fact, it is [I don’t know]. This kind of phenomenon is still very common. It is estimated that, In Britain, This is the case for half of the patients who go to general clinics, And one-third of the patients went to the hospital [1]. In a North American survey, For the first time, because of chest pain, dyspnea, A patient who goes to see a doctor with dizziness, headache, Only 16% can detect organ lesions [2]. In other words, In fact, at least one and a half patients, Doctors can’t make a definite diagnosis. Doctors don’t know how to explain to you what we often hear. It is the patient who has some incurable disease. Doctors can’t decide how best to inform patients and their families. But in fact, Most of the time, Doctors and patients face a different kind of problem, Even if the doctor cannot explain to the patient what he has, It’s what. For doctors, In fact, how to control the patient’s condition, Between the diagnosis and the diagnosis, It doesn’t have to be causal. It can’t be diagnosed, It does not mean that there is no cure, It can’t be relieved. But for patients, Just like my friend, I don’t even have a disease name, I can’t explain it to my family, and I don’t have the chance to go home and learn more about it online. Originally, doctors only need to tell the patients the relevant information truthfully and make the most objective and scientific answer. However, such an answer cannot guarantee the expected effect. Offended patients? A few years ago, several researchers from two hospitals in Edinburgh, I did two interesting experiments, See how the doctor describes a disease that cannot be diagnosed. And the patient’s reaction. [3] [4] They were in a neurological clinic in Edinburgh. Nearly 100 patients were interviewed continuously. The process of the experiment is about this. Before seeing a doctor, They asked the patients to take part in a questionnaire survey. They asked the patients to imagine a possible physical symptom. Then tell the patient that after examination, Everything is fine, Then gave the patient 10 different diagnosis results, The patient’s reaction, From this, we can derive an offense index of disease names to patients. In the first experiment, They chose the symptom of weakness. For this kind of situation, If there were no organ lesions, In ancient times, the term “hysteria” was used. But by the end of the 19th century, A more scientific-sounding term [functional weakness] began to be used. By the 20th century, Considering that the symptoms are more likely to be purely psychological, The word [psychosomatic weakness] began to be used. Finally, by the end of the 20th century, [Medically Unexplained Body Symptoms] Becomes Mainstream, Until now. So the experimenter called these methods, And other terms, Even [stroke], [Multiple Sclerosis] This almost impossible disease was put in. As a result, If the doctor’s answer is [these symptoms are purely psychological], More than 90% of patients will think they have been offended by doctors. And like [hysteria], [Mental and Physical Deficiency] Such a name implies that the patient has psychological problems, It will offend nearly half of the patients. Even the statement [medically inexplicable group of physical symptoms], More than 30% of the patients also felt offended. On the contrary, the [functional weakness] invented in the 19th century only slightly more than 10% of the patients were not satisfied. And if the doctor said the patient had [multiple sclerosis], Few patients will feel dissatisfied. Next, The researchers turned the experiment to pseudoseizures. These [pseudoseizures], Like the weakness mentioned earlier, Has been given different names. For example, in the 19th century, Doctors like to use the term “hysterical-epilepsy”. In recent years, Non-epileptic attack disorder or psychogenic non-epileptic seizures is becoming more common. In the Edinburgh Clinic survey, Not surprisingly, If the doctor’s answer is [these symptoms are purely psychological], Nearly 90% of patients feel offended, And half of the patients have great opinions on [hysterical epilepsy]. The medical profession now believes that the most objective and scientific [pseudoepilepsy], [Psychological non-epileptic seizures], and [non-epileptic seizures], It is also considered offensive by 20% to 30% of patients. On the contrary, [epilepsy] has no objection. Even [functional epilepsy] invented by the author, Only 5% of the patients were dissatisfied. The two real collisions in the eyes of medical researchers, Every diagnosis can be wrong, This error can be the failure to diagnose a disease, It can also be to diagnose diseases that do not exist. Doctors naturally think that, In giving the cause of the disease, To balance the two possibilities, Give the most objective, The name of the most comprehensive and reasonable explanation of possible situations. Like [medically inexplicable group of physical symptoms] [non-epileptic diseases], This is how to balance it, It seems to be the most objective term. But for patients, They obviously think differently from doctors. The exaggeration of the danger of various diseases in today’s society, May have made them prefer to be misdiagnosed as seriously ill, They don’t want to be ill and haven’t been found out. They believe more in their feelings: Of course, these symptoms can’t be imagined by me. Of course, I came to see the doctor because I had a problem. I can’t find out, It was the doctor’s dereliction of duty, And you want to just get rid of me, You have to prescribe some medicine. Therefore, any term that emphasizes or implies that the disease may be a psychological problem, It is easy to arouse the dissatisfaction of patients, Although they may be closer to reality. So, These two truths, Scientific truth and personal truth sometimes lead to misunderstanding and aggravate the contradiction between doctors and patients because of improper communication with each other. Fortunately, my friend went home, checked again, studied his own life and rest, tried according to the doctor’s words, and gradually believed it. Now he is the most tightly dressed person here. [2] Kroenke K, Mangelsdorff D. Common symptoms in armed care: incidence, evaluation, therapy and outcome. Am J Med1989; 86: 262-6. [3] Stone J, Wojcik W, Durrance D, et al. What should we say to patients with symptons unexplained by disease? . BMJ2002; 325: 1449-50. [4] Stone J, Campbell K, Sharma N, et al. What should we call pseudoseizures? The pathetic’s perspective. Seizure 2003; 12: 568-72.