If you feel uncomfortable and feel sick, you naturally want to go to the doctor. Even if the doctor does not have a cure, but at least a professional point, give a definitive diagnosis. This is the mindset of most people who come to see a doctor.
However, the disease is something that is actually defined by people, for doctors, all kinds of can be said and felt, is the symptom, and the name of the disease is just an invented word, is our generalized summary of some specific combination of symptoms.
The problem is that in real life, there are indeed many situations that are difficult to diagnose, despite the symptoms. The scientific name for this condition is Medically Unexplained Physical Symptoms (MUPS). (Medicallyunexplainedphysicalsymptoms, MUPS), which actually means “I don’t know”. This phenomenon is still very common. In the UK, it is estimated that half of the patients who go to general practice have this condition, and 1/3 of those who go to hospital have it, while in a North American survey, only 16% of patients who first went to the doctor for chest pain, dyspnea, dizziness, headache, etc. were able to detect an organ lesion.
1. In other words, at least half of the patients are not diagnosed by doctors.
2. Doctors don’t know how to explain to you. We often hear that a patient has an incurable disease and the doctor can’t decide how to best inform the patient and the family about it. But in fact, most of the time, doctors and patients face a different kind of problem, that is, doctors can not explain to the patient what he has, in the end, what is a disease.
For the doctor, there does not have to be a causal relationship between how to control the patient’s condition and the diagnosis. Just because a diagnosis cannot be confirmed does not mean that it cannot be treated or alleviated. But for the patient, there is no name for the disease, no way to tell the family, and no chance to go home to the Internet for further information.
Originally, the doctor only had to tell the patient the relevant information truthfully and give the most objective and scientific answer, and that was all. However, such an answer is not guaranteed to achieve the desired effect.
3. An offended patient?
Some years ago, several researchers from two hospitals in Edinburgh, made two sets of interesting experiments to see how doctors describe an undiagnosable condition, with the patient’s reaction.
They interviewed nearly 100 consecutive patients who came to a neurology clinic in Edinburgh. The experiment went approximately like this; before the visit, they had the patients take a questionnaire. They asked the patients to hypothesize a possible physical symptom, then told the patients that everything was normal after the examination, then gave the patients 10 different confirmatory results to see how they reacted and from that they introduced an index of how offensive the name of the disease was to the patients.
In the first experiment, they chose the symptom of weakness and weakness. For this condition, if there were no organ lesions, the ancient term “hysteria” was used. But by the end of the 19th century, another, more scientific-sounding term, ‘functional weakness’, came into use. By the 20th century, the term “psychosomatic weakness” came into use, considering that the symptoms were more likely to be of a purely psychological nature. It was eventually by the end of the 20th century that medically unexplained somatic symptoms became mainstream until now.
So the experimenters put in these calls, and a few others, even including stroke, and almost impossible diseases like multiple sclerosis. As a result, if the doctor’s answer was “these symptoms are purely psychological,” more than 90% of the patients would feel offended by the doctor. And names like hysteria and psychosomatic weakness, which imply that the patient has a psychological problem, will also offend nearly half of the patients. Even the term “medically unexplained somatic symptoms” offends more than 30% of patients. On the contrary, only slightly more than 10% of patients were dissatisfied with the term “functional weakness”, which was coined in the 19th century. And if a doctor said that a patient had “multiple sclerosis,” few patients would be offended.
Next, the researchers turned their experiments to pseudo-epilepsy. These pseudo-epilepsies, like the previously mentioned weakness, were given different names. For example, in the 19th century, doctors liked to use terms like ‘hysterical epilepsy’. And in these recent years, non-epileptic seizure disorders or psychogenic non-epileptic seizures are slowly being commonly adopted.
In the Edinburgh Clinic survey, not surprisingly, nearly 90% of patients felt offended if their doctor’s response was that the symptoms were purely psychological, and half of the patients had strong opinions about ‘hysterical epilepsy’. Pseudo-epilepsy”, which is now considered the most objective science by the medical community, psychogenic non-epileptic seizures, and non-epileptic seizure disorders, were also considered offensive by 20% to 30% of patients. On the contrary, “epilepsy” is the most uncontested. Even “functional epilepsy”, which was invented by the authors, was considered unsatisfactory by only 5% of the patients.