An interesting new program at the NIH. The Undiagnosed Diseases Program has two goals:
- To provide answers to patients with mysterious conditions that have long eluded diagnosis
- To advance medical knowledge about rare and common disease.
It has some really powerful support from the National Human Genome Research Institute, the NIH Office of Rare Diseases and the NIH Clinical Center. The specialties will span from dermatology to cardiology.
Well, back in Happy's land, the elusive diagnosis is usually explained away by one of these real world examples.
- Ma'am, you've got no physiological explanation for using 400 mg of Morphine in a 24 hour period. It's time to go home.
- Ma'am, your 10 CT scans of your abdomen in the last twelve months, your three upper endoscopies, your two colonoscopies, your CT angiogram of your belly, your PET scan, your exploratory lap, your cholecystectomy, hysterectomy, spleenectomy and your 400 pages of lab tests have failed to give us an alternative diagnosis to your irritable bowel syndrome.
- Your 3 MRI's, MRA's and MRV's, your lumbar puncture and your 300 pages of labs have failed to convince you that you have migraines. But not us.
- Your pain that starts in your left knee and shoots to your inner pelvis, then takes a right angle turn and heads for your spleen, where it turns into a dull ache as it travels to your opposite shoulder, on a pit stop to your right eye. Ma'am that pain is ... Why don't we have your psychiatrist come talk to you.
- Ma'am everything hurts. I understand that. You've got fibromyalgia. What would you like me to do for you in the hospital?
To everyone up there at the National Sounds Important Institute, let me know if you need some help.
Ma'am, you are suffering from Retrobulbar Micturalgia, an undiagnosed medical condition. You need to see a psychiatrist.
ReplyDeleteWhat hospital do you guys work in again, so I can avoid it?
ReplyDeleteFunny, I have no trouble with the ma'ams. I have more trouble with the men who cuss and scream and bully the nurses.
ReplyDeleteSounds like pretty reasonable hospitalists to me. Every day, we have dozens of people showing up to our emergency apartment demanding narcotics for all sorts of complaints. The point where a patient in this all of the FDA approved opioids is the point when he becomes an abuser of the system.
ReplyDeleteAnon,
ReplyDeleteIf you don't think its funny we don't want you in our hospitals.
So.... here's the thing I don't understand, esp with the migraine thing. My migraines presented themselves with a week of the worst headache of my life when I was a resident (status migraine or something like that).
ReplyDeleteI was so relieved to find out that it was a migraine (and then even more relieved when a combo of naproxen and relpax and some rest made that headache go away). Why is it that people don't want to believe they have migraines when they are treatable and not particularly life threatening? I would rather have a migraine than an SAH (even though migraines can be annoying, they're treatable, and again, not a brain hemorrhage or a tumor).
I may never understand some people, I suppose....
I do think you're funny and I'm glad I found this blog. Nonetheless, the problem with the "ma'am -- how would you like to see our nice psychiatrist?" theme is when a depressed, somatizing person also has something actually wrong. As a congenital somatizer (my mom can give herself pneumonia to get out of uncomfortable situations), I accepted for years that my dozing off in the daytime was just one more gift of bad neurotransmitters. Turns out I needed my nasal airways roto-rootered. You would think with sleep apnea being last year's fad diagnosis, somebody would have thought of it. But, "ma'am, just keep seeing your nice psychiatrist" trumps all. Of course what's most hilarious is the Freud and Fleiss would have sent an hysteric such as myself for nose surgery, for all the wrong reasons.
ReplyDelete