I have an ulcer.
If you’re wondering where I’ve been, you must be an odd and lonely person. Anyways, taking my last test before graduation next month, then flying off to darkest Africa to play doctor one last time before, uh, the real thing. Oh, and I find out where I’m going to be spending my next three (+?) years this Thursday. Indeedy.
Anyways, between the studying and the packing and the intense anxiety about the future, blogging seems a poor investment of my time. But what the hell.
So, anyways, I’ve been thinking that people who complain about overdiagnosis aren’t complaining about overdiagnosis, but that our diagnostic categories and therapeutic options are crude and impractical. There’s no intrinsic difference between mastering your emotions through force of will or force of pill, and anyone who tells you different just hasn’t had the right pills. Because they don’t exist.
Similarly, a common complaint about modern medicine you hear from the holistic types is that it treats the symptom, not the disease. This isn’t entirely accurate, but who cares? Without symptoms, there is no disease. The problem with modern medicine is that it treats symptoms poorly, and with gross side effects.
i’m particularly fond of the medicines that have side effects equivalent to the symptoms they are treating, such as allergy medications that give you a headache. hmm…stuffy nose and headache, or just headache (oh, and maybe nausea)? really, what’s the point?
even better are the side-effects that are vastly worse than the symptoms they are treating, such as psiorisis medications that may kill you. itchy, flaking skin, but alive or clear skin and death? again, it seems better to just deal with the disease.
Comment by twiffer — March 19, 2008 @ 12:41 pm
Good luck with residency (I assume that’s what you mean about the 3+ years?).
I have a recurring argument with mrs. august. Me: I think holistic medicine/acupuncture/whatever is kind of idiotic. mrs.a: But you study Chinese history. Me: Exactly.
I lose the argument, partly because she’s been the sick one lately, and mostly because I always lose the argument.
I’ve been pleasantly surprised by the doctors I’ve encountered in the past couple of months. I’m grateful for their willingness to admit it when they don’t know something. I find it oddly reassuring (the implication being that they know what they know).
Comment by august — March 25, 2008 @ 10:12 pm
Twif: My (and probably many others) new favorite is mirapex, which treats restless leg syndrome (no doubt very hard to live with) but advertisements say causes pathological gambling.
August: Yep, residency. I have a few friends who are going to Beijing for a month to study acupuncture. My school has partly funded their trip and is giving them course credit. I have mixed feelings. They’re getting to travel a bit before internship, and they probably couldn’t afford to go on their own. On the other hand, we are forbidden (most of whom are in serious debt) from accepting free meals and pens from pharmaceutical companies because of the inherent conflict of interest, so it seems to me a half-paid vacation to learn pseudoscience (which is what acupuncture is, regardless of efficacy) can only be viewed as a tacit endorsement of the practice.
My own experience as a patient over the past year+ (nothing too serious, thankfully) has been illuminating. It’s very hard not to catastrophize even when the statistics are in your favor, and it’s very hard to distinguish placebo effects from real ones.
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Comment by DoctorsHangout.com — April 1, 2008 @ 2:56 am
Triptans! Thank the God of Pharma for triptans. I had a $60 headache last week. If I had purchased the pills (4) in the US, it would have been a $92 dollar headache, and it would still have been a bargain.
I’d love to hear your take on Africa. I’ve only been to Morocco and Egypt, but would go longer and farther on that continent than on any other, if I had the opportunity.
Comment by Dawn Coyote — April 4, 2008 @ 1:14 am