The curious illness

September 10, 2010

One doctor recounts his recovery from a curious and not completely diagnosed illness.

Key Points

I am now recovering from a curious and still not completely diagnosed illness. I am better, but I missed work for over a month, had a lot of tests, several ER visits, and even a laparoscopy. The bad news is there is no definitive diagnosis, and I'm still not completely over it. The good news is that I am better, and nothing bad was found. At this point, I'll gladly settle for that. But it was an unpleasant and disturbing process.

However, to make peace with my illness, I need to learn from it. I believe I can now go forward and take better care of my patients-and myself.

What did I learn?

We cannot rid our patients of these thoughts, but we can reassure them that such thoughts are not unexpected, and we can be supportive and attentive while they experience such thoughts. Don't assume patients are handling an illness well. Ask, "Are you having some difficulties coping with this?"

It's difficult to wait. Waiting for tests to be scheduled or test results to come back was very frustrating. Although I knew that short delays were of no medical importance, waiting was tough. I have always been good about getting tests scheduled and results back to patients quickly, but I'll do even better now. Less waiting means less anxiety, which is important.

Being ill improves your hearing. Waiting in offices or exam rooms, I could hear everything-the nurse complaining about her babysitter, the tech with a headache, the physician who was waiting for a call from his cell phone representative. And I didn't like hearing any of it. I wanted everyone's undivided attention. Back in the office, I reminded my staff how careful we must be when interacting with patients-and how aware we must be of whatever else we are doing. "Do make them the top priority," I told my staff (and reminded myself).

Patients always think the worst. I don't think my physicians ever thought I had a terminal illness, but I did. There were times I knew I was about to die-exactly how and when were the only remaining questions. Despair trumps logic. So what to do as a physician? Address the issue, and since your patients are already thinking of them, use the words "cancer" and "death," even if neither one actually seems a possibility. "I know things are not going well, but there's some good news. We have no evidence that this is a cancer and nothing to suggest this is a terminal disease. So let's work on getting you well."

Tests can be therapeutic. So many articles now say we do too much testing, but sometimes it's the right thing to do. Sure, I had a lot of tests, and in retrospect, I might have been fine without some of them. But there can be a benefit from a normal test result. Hearing that I didn't have "X" made me feel better, even though my physician-and I-doubted it before the results came back. I have always tried to order tests appropriately; I shall continue to do so, but I may be a bit quicker to order certain ones now if I know my patient is fearful of something and will feel better once that concern has been addressed.

The Internet doesn't work for everyone. We keep hearing about patients going online for information, and we are told to provide them with Web sites and more information. That works for some people, but not for all. During my illness, I had very little interest in turning to the Internet-and spent little time with medical literature as well. I found myself wanting to be the patient and let my doctors do the research.

I shall continue to offer information to patients who want it, but I'll also be comfortable with those who don't want to surf the Web and prefer my telling them what needs to be done. "I trust you, doc," is a compliment.