Plain truth

[Perrotfish]

Oh I hope I didn't mean to say that compassion is useless at all. Since yes, compassion is a positive thing to have as a physician!

the thing which made me at the OP how she throws around the word compassion. I'm guessing someone was watching too much Patch Adams and was mad when the doctors in real life weren't like that...

She's someone with some kind of chronic disorder, misdiagnosied or undertreated by a series of physicians, who finally got fixed by someone who took the extra time. It was an impressive example, to her, of the difference between a physician who cares and one who doesn't

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[45408]

Because doctors have lives in their hands, LIVES. if they are not that passionate about medicine they should turn to another profession that does not involve so many responsibilities and that can be easily done without any passion for it. I named a few but there are many more. Nowadays patients don't even interact much with their doctors, they only rush for prescriptions, they don't care about you, and it seriously hurts me because you can screw up at any other job and get a second chance, but if you screw up in medicine, you can't get these lives back

You've got the best and brightest in medicine now. Your posts just hurt my brain.

 

[Thego2guy]

Just a premed here, so pardon the ignorance, but since the topic has been raised, why are statements such as "oh its just all in your head" still used? So what if its all "in my head"? That is still a source of a problem. If I have a tumor in my pancreas, then saying "Oh its all in your pancreas" is not going to help. The problem needs to be treated regardless of where it is. I was reading a lot about IBD (reminding you all that I am just a premed), and sometimes I can relate to those symptoms. I am not as anxious as I used to be, but I still have a lot of experience with that, and I can 'understand' the brain-gut connection. Saying "fu-k it, its all in your head, you *****" doesn't mean ****. Yeah, its in my head. My head is made out of cells. It is clearly a molecular, tangible issue.

I presume the problem here is that there is a fine line between psychiatry and neurology, and 'non-organic' vs. organic brain disorders. If we really want to be technical, then technically, all brain disorders are organic in nature, right? And all of psychiatry is a giant subdivision of neurology? Correct me if I am wrong, I am not trying to troll, just trying to understand why 'in-organic' brain disorders deserve less merit and attention than 'organic' ones. Wtf does organic even mean? Something measurable? So because we can measure decreased dopamine levels in a Parkinson's patients, and ADMINISTER a physical drug such as levadopa, then its okay, because its organic, and its legit. But if someone has DID, or chronic pain, or some other psychiatric disorder, than its not okay because I can't measure the effects of whatever crazy neurochemistry interactions that go on in the persons head, so its not organic, and ergo, should not be taken as seriously?

Thanks for your input guys

 

[SpecterGT260]

where did we establish the gender of the OP?

Just a premed here, so pardon the ignorance, but since the topic has been raised, why are statements such as "oh its just all in your head" still used? So what if its all "in my head"? That is still a source of a problem. If I have a tumor in my pancreas, then saying "Oh its all in your pancreas" is not going to help. The problem needs to be treated regardless of where it is. I was reading a lot about IBD (reminding you all that I am just a premed), and sometimes I can relate to those symptoms. I am not as anxious as I used to be, but I still have a lot of experience with that, and I can 'understand' the brain-gut connection. Saying "fu-k it, its all in your head, you *****" doesn't mean ****. Yeah, its in my head. My head is made out of cells. It is clearly a molecular, tangible issue.

I presume the problem here is that there is a fine line between psychiatry and neurology, and 'non-organic' vs. organic brain disorders. If we really want to be technical, then technically, all brain disorders are organic in nature, right? And all of psychiatry is a giant subdivision of neurology? Correct me if I am wrong, I am not trying to troll, just trying to understand why 'in-organic' brain disorders deserve less merit and attention than 'organic' ones. Wtf does organic even mean? Something measurable? So because we can measure decreased dopamine levels in a Parkinson's patients, and ADMINISTER a physical drug such as levadopa, then its okay, because its organic, and its legit. But if someone has DID, or chronic pain, or some other psychiatric disorder, than its not okay because I can't measure the effects of whatever crazy neurochemistry interactions that go on in the persons head, so its not organic, and ergo, should not be taken as seriously?

Thanks for your input guys

it isnt so much to mean the location of the problem as it is to denote the source of the "severity". I could have a pimple and perceive it as a death sentence. that doesnt make it true. This is a problem with chronic pain... some people are just wimps, but apparently we arent supposed to say that. A friend of mine constantly complains about all sorts of phantom ailments, many of which do not make any sense. A part of me is convinced that she has an unreasonable expectation for (and correlation between) "comfort" and "health", any perceived discomfort gets compounded with some believe that it denotes disease. Like I said, some people are just wimps. But you open yourself up to liability if you say this and it turns out you are wrong.

Also, When I hear "it's all in your head", I usually take it to mean that the person is perceiving an issue that is medical rather than psychological or psychosomatic. yes, it needs to be treated, but treating a psychological issue with medical (non-psychiatric) techniques is no different than treating a malignant tumor with a bandage. Simply inappropriate

 

[45408]

I will be a....physician

Not so sure about that...

 

[Perrotfish]

it isnt so much to mean the location of the problem as it is to denote the source of the "severity". I could have a pimple and perceive it as a death sentence. that doesnt make it true. This is a problem with chronic pain... some people are just wimps, but apparently we arent supposed to say that. A friend of mine constantly complains about all sorts of phantom ailments, many of which do not make any sense. A part of me is convinced that she has an unreasonable expectation for (and correlation between) "comfort" and "health", any perceived discomfort gets compounded with some believe that it denotes disease. Like I said, some people are just wimps. But you open yourself up to liability if you say this and it turns out you are wrong.

That's one possible explanation, but another is that her nervous system really is malfunctioning. The nervous system is a physical organ like any other, and its acted on by the same medications that we use to treat psychiatric disorders. Its perfectly possible that the reason that so many chronic pain disorders are often comorbid with more obervable disorders like Irritable bowel or cyclic vomiting syndrome is that a subset of the population has chronic problems recieving/transmitting/interpreting sensory data. That wouldn't be a psych disorder.

 

[SpecterGT260]

That's one possible explanation, but another is that her nervous system really is malfunctioning. The nervous system is a physical organ like any other, and its acted on by the same medications that we use to treat psychiatric disorders. Its perfectly possible that the reason that so many chronic pain disorders are often comorbid with more obervable disorders like Irritable bowel or cyclic vomiting syndrome is that a subset of the population has chronic problems recieving/transmitting/interpreting sensory data. That wouldn't be a psych disorder.

but that is not what was meant by "it's all in her head". The question I was addressing was "what does it mean when someone says".......... you know what? nevermind

 

[Aerus]

OP, if I had to predict the future now, you would:

1) Probably not even make it to medicine. You sound like you're just complaining that you didn't get accepted to any medical schools this cycle and are blaming others who took your spot, so you're complaining why they got in when they probably have bad reasons for getting in.

Sorry, but whiny attitudes don't really get you far. You need to take responsibility for yourself in order to make it to medical school and survive.


2) Become one of those "Crappy doctors" you say are so bad. They're human. You're obviously a premed and still have a lot of growing up/realizing the world to do. Shadowing/volunteering does not expose you ENOUGH to the realities of the patients.




I'm still a premed too, but through MY experiences, patients can be some of the most whiny, self-deserved, egocentric, and "high on my horse I'm more important than all of the other patients" people in the whole world.

You say that "I'm going to be a great doctor and be compassionate to every patient I have and love everyone and go the extra mile!", I can bet that you aren't. Some patient out there will piss you so much that you will lose it. And imagine getting that patient at least once a day.

And NO, compassion+passion+whatever-sion does NOT = good doctor. If I diagnose a patient for something and give them the drugs, I can do this with or without compassion.

WITH PASSION/COMPASSION/WHATEVER-SION = less likely chance of malpractice suit and happier patient.
WITHOUT PASSION/COMPASSION/WHATEVER-SION = unhappy patient calling you a "Crappy" doctor.
BOTH = healthy patient, as far as the current science of medicine will allow.

You have A LOT of growing up to do. You're still stuck in this idealistic, barbie fantasy, "doctors are supposed to be gods and not be humans and love everyone a lot" world.

By the way, a few people have already proved your point wrong. There's really no point in continuing this debate if you're not going to address their points and ignore everyone who proves you wrong.

 

[dbeast]

Some patients with chronic pain conditions don't want to get well. Their identity becomes their disease and it gets them tons of attention for it. As soon as you're not sick, you're not special anymore. Once again, psych issue.

 

[Morsetlis]

I have a female friend with Fibromyalgia.

Guess what every other Facebook post is about?

 

[KnuxNole]

I'm guessing lots of "If you can't handle me at my worst, you don't deserve me at my best! <3"

 

[STAT EKG]

I'm guessing lots of "If you can't handle me at my worst, you don't deserve me at my best! <3"

 

[Morsetlis]

 

[Instatewaiter]

That's one possible explanation, but another is that her nervous system really is malfunctioning. The nervous system is a physical organ like any other, and its acted on by the same medications that we use to treat psychiatric disorders. Its perfectly possible that the reason that so many chronic pain disorders are often comorbid with more obervable disorders like Irritable bowel or cyclic vomiting syndrome is that a subset of the population has chronic problems recieving/transmitting/interpreting sensory data. That wouldn't be a psych disorder.

When you take a fibromyalgia patient and treath them with cognitive-behavioral therapy their fibromyalgia gets better. When you tell them to sack up and go for a walk, their fibromyalgia gets better (just as much if not more than cymbalta). This is a "interpretation" problem but that doesn't make it any more real. In my opinion it is one facet of their depression/anxiety. There is a reason that depression comes with pain. It affects the sensory interpretation. FIbromyalgia is just on the end of that spectrum. It still doesn't make that pain any more real. It literally is all in their head.

I have a female friend with Fibromyalgia.
Guess what every other Facebook post is about?

Her 12 cats?

I have to say, it pisses me off that lupus is thrown in there with chronic fatigue and fibromalgia. WIth our rheum dept here at hopkins, I get to see some of the worst lupus has to offer. Lupus is a real (when diagnosed using the correct criteria) and devastating condition. It is a nasty, nasty disease to have. If you have ever seen a true lupus flare that causes hospitalization, it looks nearly identical to sepsis. It is some scarry **** that kills people. Have some respect for lupus because when it rears its ugly head all you can do is slam the patient with steroids, antibiotics and pressors and pray something works before they die.

Compare that to chronic fatigue or fibromyalgia. When these conditions rear their ugly heads there is not a single ounce of objective clinical data. Patient comes in screaming to my office in 12/10 pain (yes twelve out of ten pain) with a heart rate of 75. It is hard to say that has orgnaic pain. If I were to step on your toe really hard your heart rate would go up to 100 at least and you all would probably at worst say it was an 8/10.

 

[45408]

I have a female friend with Fibromyalgia.

Guess what every other Facebook post is about?

Probably like my Facebook friend with endometriosis. Not sure what kind of replies she wants, or if it would be a good thing or a bad thing to like her status updates.

 

[SpecterGT260]

I have a female friend with Fibromyalgia.

Guess what every other Facebook post is about?

boy troubles and/or passive aggressive statuses about "not liking drama"?

 

[Larynx]

Just a question to residents/students who frequently encounter fibromyalgia patients. Are they a lot like this woman? (The first woman interviewed)
[YOUTUBE]mDRESh8MmxI[/YOUTUBE]

Because uhh.. she seems a little dramatic.

But I actually agree a lot more with Perrotfish. It doesn't seem likely that so many millions of people would independently "somatize" their symptoms to such a specific degree as to be able to identify trigger point locations without there being some type of physical cause that explains this consistency.

One can say that well it's the internet and so they google the symptoms and just take on the symptoms that they read. However, Fibromyalgia has been around for a long time, before even the internet was widespread and certainly a lot of patients haven't heard of fibromyalgia before they were diagnosed and it's reasonable to expect many of them were in a state of ignorance where they wouldn't be able to replicate the symptoms through their mental components alone.

Now of course I don't know, no one knows for sure. I'm just saying let's be objective about it. Well with the exception of making fun of the crazy personalities some people exhibit, like the person in the video. Because that's just funny.

 

[45408]

Just a question to residents/students who frequently encounter fibromyalgia patients. Are they a lot like this woman? (The first woman interviewed)

Because uhh.. she seems a little dramatic.

Welcome to the poster child for fibromyalgia patients.