Am I Crazy?

As a physician, I encounter patients who have complaints that seem to make no sense.  Either there are too many vague symptoms which point to absolutely nothing, or they are complaining about multiple different issues, that it seems they are trying to find something wrong with themselves.Others times, they are struggling to put into words exactly what they are feeling.

A lot of times physicians dismiss them as invalid or crazy. And sometimes they are right. Sometimes patients have mental disease that cause them to have paranoia or hypochondriasis ( Side note: I am not calling these people crazy, I do not refer to anyone with mental illness as crazy).Frequently you are faced with malingerers who are making up symptoms simply for some kind of gain such as  time off work, opioids, or government or disability benefits.

But sometimes we are very wrong.

A few weeks ago, I was having some vague symptoms. I was feeling feverish and had chest heaviness with mild discomfort breathing or taking a deep breath. It wasn’t the typical shortness of breath and chest pain of pleuritis that I’ve had before.I tried explaining my symptoms to the nurse at the doctors office so she could tell the doctor, but struggled to really express how I was feeling.She called back later ( Yes, the doctor never spoke to me himself) and said the doctor says ” Just go to the ER”.

At this point I’m starting to feel like I’m crazy. I know I’m not sick enough to go to ER, but I know I’m not well. I explain what I’m feeling to the people at work, all while looking perfectly healthy, and they are looking at me like I’m crazy. My parents are telling me I’m probably just getting sick and should rest. I go to a cardiologist, have an EKG and echo, and they find nothing. I listen to myself explaining how I feel, and realize as a physician it doesn’t even make sense to me.

Eventually it gets better on its own, and I’m left wondering what was really wrong with me. Perhaps I will never know. But it reminded me of a lesson I learned early on in the course of my disease. Always take everyone seriously. Listen to their complaints carefully and completely. And if I can’t make sense of it, send them to a specialist who might be able to. Never write anyone off as crazy.

2 thoughts on “Am I Crazy?

  1. I’ve been telling my internist for three years that I have a brain tumor. It’s the only way I knew how to describe the pain in my head. Me did an MRI and eventually an MRI/MRA and told me , “No brain tumor.” After that, every time I brought it up, he rolled his eyes at me. Fast forward three years later, a fantastic neurologist, and a spinal tap and I find out that I’m overproducing spinal fluid like crazy and that according to my neurologist, “It feels exactly like you have a brain tumor, there’s just no physical tumor present.” So yes! Please listen. We are not crazy.

  2. Having Lupus makes you a `high-risk` patient, so any new symptom should be taken seriously. I would never dismiss a patient with an autoimmune disease on immunosuppressant drugs.

    With regard to the `rest`of the people, i think that taking patients´ concerns seriously is benefiting both the doctor and the patient. A patient who doesn´t feel listened to / is being dismissed without some solid medical ground, will become more worried, stressed, loose confidence in its own judgement, have others in the family consider him/her as hypochondriac, look for other doctors and so on.

    Having a chronic disease can certainly give you the empathy that other `doctors`might not have, but one must not loose that fine medical objectivity that is attained after some years of practice which helps discern the real medical problems from more `soul`-like problems ( which are not to say unreal, but demand another type of `treatment`).

    Seems like you have found a job in the end. Hope is meeting your `demands`.

    A.

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