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Because doctors in the western medicine tradition don't always accept a patient's symptoms at face value. The person in the story got referred to psychiatry be

Because doctors in the western medicine tradition don't always accept a patient's symptoms at face value. The person in the story got referred to psychiatry because medicine didn't believe him. Similarily, many legit medical disorders are discounted as not real symptoms by western medicine until decades later, for example, lyme disease, which is caused by a real organism with a real transmission pathway (ticks), with repeatable symptoms, but was discounted for years as "patients just making things up".

BurningFrog 7y ago
For my money it was just an ordinary cock up.
IAmGraydon 7y ago
Personal anecdote, but I’ve been tested for elevated adrenaline on 2 occasions just from complaining of facial flushing. Sometimes this will even be tested in a yearly physical. Surely, over a decade of interacting with doctors would have led him to this common test.
- DataWorker 7y ago
  Where do they do yearly physicals? You must not have hmo coverage.
  - jdavis703 7y ago
    My HMO, Kaiser Permanente, does free or cheap annual physicals. In fact they will beg/harass you to take them. I'm assuming they have data showing 15 minutes once a year saved them big money when they can catch expensive issues early.
    - DataWorker 7y ago
      Well I guess it depends on what you call an annual physical. Check vitals + simple blood test may be cost effective. Generally the evidence is against the benefits of annual physicals and any cost conscious hmo knows that. Edit: here’s more on the subject https://www.health.harvard.edu/blog/a-checkup-for-the-checkup-do-you-really-need-a-yearly-physical-201510238473 https://www.health.harvard.edu/blog/a-checkup-for-the-checku...
      - jdavis703 7y ago
        That's essentially what their physical is. Now I'm thinking a "real" physical might involve more diagnostics? Edit: A scan of the internet seems to show most physicals are checking vitals, blood tests, and some lifestyle questions... unless you're old or have an existing health complication in which they check more stuff. Also I'm vegetarian so I like to check iron, creatine and B-12 levels. And I like to take the opportunity for a free STD check.
  - azinman2 7y ago
    Where don’t they in the developed world? I’m confused by your comment.
vanderZwan 7y ago
Yeah, the Lyme disease story checks out. My aunt had a mysterious disorder that left her in constant pain for years. She lived in Canada. Then, during one of her visits to us in the Netherlands, one of my uncles (her oldest brother, a neurosurgeon) suggested that her symptoms were very similar to Lyme disease. Even knowing the likely cause of the disease, the first two doctors she visited flat-out refused to have her tested for it and told her that she was just being hysterical. Note: she was a head nurse and the textbook definition of "walk it off".
- sjg007 7y ago
  You can't treat lyme disease years after the initial infection. So they really only test if you see the bulls eye rash and prescribed antibiotics. I think they might just prescribe the antibiotics if they see the rash. The knee swelling and pain comes much later. So what the doctors said was in fact correct. https://www.mayoclinic.org/diseases-conditions/lyme-disease/diagnosis-treatment/drc-20374655 https://www.mayoclinic.org/diseases-conditions/lyme-disease/...
  - vimy 7y ago
    This is incorrect and based on outdated research. The research that shows persistent Lyme is real is piling up but the medical community seems slow to accept this fact.
    - sjg007 7y ago
      Citation? The CDC and NIH disagree with you. https://www.cdc.gov/lyme/postlds/index.html https://www.cdc.gov/lyme/postlds/index.html
      - asveikau 7y ago
        Both this article and the mayo clinic one say that post Lyme disease syndrome is real and without a cure. So if she did have PLDS and the commenter is correct and that the doctors simply called her "hysterical" and left it at that then it cannot be said that they were correct.
legohead 7y ago
Just watch a season of Mystery Diagnosis to lose faith in doctors, or at least begin to understand they don't have all the answers. It's story after story about people asking for help, doctors telling them to "Just go home and wait a while and see what happens," until the person figures out the problem themselves and struggles to find a doctor that believes them.
fiblye 7y ago
I’ve got a relevant experience to back this up. I had a urinary tract infection that I felt progress up to my bladder and eventually into one kidney and then the next. I would’ve liked to visit a doctor immediately, but with American medical costs being what they are and hospitals advising me to hold out a few more days until a doctor in my insurance network was available, I’d hoped that small stinging pain down there would go away. But nope, it spread to all the regions mentioned plus I was passing blood almost nonstop. I couldn’t sleep, could barely walk, and felt like I was on the verge of dying. I made it to a doctor once I knew it was a life or death situation, described my symptoms and the progression, and the guy starts digging into me, trying to say I’m just fishing for antibiotics (what?) and it’s clearly a kidney stone. I all but called him a dumbass, because it wouldn’t make sense for a kidney stone to move backwards up to both of my kidneys. I had to wait around for a urine test to prove that yes, it was in fact an obvious kidney infection, but the doctor was still skeptical asserting that it’s probably just a mild kidney stone, and reluctantly gave my antibiotics that cleared it up instantly. That wasn’t the first time a doctor tried to argue against my obvious problem (I also had one argue that I didn’t break a clearly broken bone), but it was the most frustrating experience.
- Foober223 7y ago
  Some doctors are idiots. No different than people in any other profession.
  - TheOtherHobbes 7y ago
    Some doctors are idiots. Some doctors are only in it for the money. Only a small proportion of the people who qualify have any genuine deep-seated urge to help fix human suffering. When doctors get it wrong, people die. Anyone who genuinely does care about human suffering is going to find that difficult. But a lot of patients are idiots too. For every educated more-or-less self-aware middle class professional a doctor sees, there are tens of patients who are old, confused, angry, hostile, lonely, unable to look after their own welfare in more or less obvious ways, or just plain dumb - and barely able to understand what their problem is, never mind explain it. So it's not an easy profession - not because doctors have to be unusually competent to do it, but because they deal with all kinds of people with all kinds of problems in all kinds of situations, and it's normal for many of those people to be very bad at being able to explain why they're there.
caycep 7y ago
It depends on the culture...I think medical culture differs from place to place. When I was in the northeast, everyone had the ambition of being the next Michael DeBakey or chief of Harvard Medical School, so we'd all run every single test under the sun. The patient'd get a huge bill later from the lab because the insurance didn't want to pay, but what the hey, we were all medical residents and didn't have to deal with the fallout (the primary cares probably did and were pissed). Out here in the west...people will roll in with some obvious diagnosis and some overworked urgent care doc seeing 60 patients a day wouldn't have bothered to ordered even the most basic tests....
busyant 7y ago
Why are you using the word "western" here? Are non-"western" healthcare practitioners exempt from biases and prejudicial opinions? I think it's fair to say that, like all humans, healthcare practitioners may have prejudicial opinions on healthcare matters that can lead to erroneous diagnoses. The western ones don't have a monopoly on this behavior.
- tnzn 7y ago
  Because this has to do with western medicine as a discipline and practice, in which we over-objectivized health care and the doctor/patient relationship is heavily asymetric. This leads to the fact that in most cases, doctors do not really listen to their patients, let alone believe them when they don't manage to find objective cues of a illness. They easily discard patients' subjective experience. Recent research is calling for a change in that aspect, and change is slowly happening.

BurningFrog 7y ago

For my money it was just an ordinary cock up.

IAmGraydon 7y ago

Personal anecdote, but I’ve been tested for elevated adrenaline on 2 occasions just from complaining of facial flushing. Sometimes this will even be tested in a yearly physical. Surely, over a decade of interacting with doctors would have led him to this common test.

DataWorker 7y ago
Where do they do yearly physicals? You must not have hmo coverage.
- jdavis703 7y ago
  My HMO, Kaiser Permanente, does free or cheap annual physicals. In fact they will beg/harass you to take them. I'm assuming they have data showing 15 minutes once a year saved them big money when they can catch expensive issues early.
  - DataWorker 7y ago
    Well I guess it depends on what you call an annual physical. Check vitals + simple blood test may be cost effective. Generally the evidence is against the benefits of annual physicals and any cost conscious hmo knows that. Edit: here’s more on the subject https://www.health.harvard.edu/blog/a-checkup-for-the-checkup-do-you-really-need-a-yearly-physical-201510238473 https://www.health.harvard.edu/blog/a-checkup-for-the-checku...
    - jdavis703 7y ago
      That's essentially what their physical is. Now I'm thinking a "real" physical might involve more diagnostics? Edit: A scan of the internet seems to show most physicals are checking vitals, blood tests, and some lifestyle questions... unless you're old or have an existing health complication in which they check more stuff. Also I'm vegetarian so I like to check iron, creatine and B-12 levels. And I like to take the opportunity for a free STD check.
- azinman2 7y ago
  Where don’t they in the developed world? I’m confused by your comment.

vanderZwan 7y ago

Yeah, the Lyme disease story checks out. My aunt had a mysterious disorder that left her in constant pain for years. She lived in Canada. Then, during one of her visits to us in the Netherlands, one of my uncles (her oldest brother, a neurosurgeon) suggested that her symptoms were very similar to Lyme disease. Even knowing the likely cause of the disease, the first two doctors she visited flat-out refused to have her tested for it and told her that she was just being hysterical. Note: she was a head nurse and the textbook definition of "walk it off".

sjg007 7y ago
You can't treat lyme disease years after the initial infection. So they really only test if you see the bulls eye rash and prescribed antibiotics. I think they might just prescribe the antibiotics if they see the rash. The knee swelling and pain comes much later. So what the doctors said was in fact correct. https://www.mayoclinic.org/diseases-conditions/lyme-disease/diagnosis-treatment/drc-20374655 https://www.mayoclinic.org/diseases-conditions/lyme-disease/...
- vimy 7y ago
  This is incorrect and based on outdated research. The research that shows persistent Lyme is real is piling up but the medical community seems slow to accept this fact.
  - sjg007 7y ago
    Citation? The CDC and NIH disagree with you. https://www.cdc.gov/lyme/postlds/index.html https://www.cdc.gov/lyme/postlds/index.html
    - asveikau 7y ago
      Both this article and the mayo clinic one say that post Lyme disease syndrome is real and without a cure. So if she did have PLDS and the commenter is correct and that the doctors simply called her "hysterical" and left it at that then it cannot be said that they were correct.

legohead 7y ago

Just watch a season of Mystery Diagnosis to lose faith in doctors, or at least begin to understand they don't have all the answers. It's story after story about people asking for help, doctors telling them to "Just go home and wait a while and see what happens," until the person figures out the problem themselves and struggles to find a doctor that believes them.

fiblye 7y ago

I’ve got a relevant experience to back this up. I had a urinary tract infection that I felt progress up to my bladder and eventually into one kidney and then the next. I would’ve liked to visit a doctor immediately, but with American medical costs being what they are and hospitals advising me to hold out a few more days until a doctor in my insurance network was available, I’d hoped that small stinging pain down there would go away. But nope, it spread to all the regions mentioned plus I was passing blood almost nonstop. I couldn’t sleep, could barely walk, and felt like I was on the verge of dying. I made it to a doctor once I knew it was a life or death situation, described my symptoms and the progression, and the guy starts digging into me, trying to say I’m just fishing for antibiotics (what?) and it’s clearly a kidney stone. I all but called him a dumbass, because it wouldn’t make sense for a kidney stone to move backwards up to both of my kidneys. I had to wait around for a urine test to prove that yes, it was in fact an obvious kidney infection, but the doctor was still skeptical asserting that it’s probably just a mild kidney stone, and reluctantly gave my antibiotics that cleared it up instantly. That wasn’t the first time a doctor tried to argue against my obvious problem (I also had one argue that I didn’t break a clearly broken bone), but it was the most frustrating experience.

Foober223 7y ago
Some doctors are idiots. No different than people in any other profession.
- TheOtherHobbes 7y ago
  Some doctors are idiots. Some doctors are only in it for the money. Only a small proportion of the people who qualify have any genuine deep-seated urge to help fix human suffering. When doctors get it wrong, people die. Anyone who genuinely does care about human suffering is going to find that difficult. But a lot of patients are idiots too. For every educated more-or-less self-aware middle class professional a doctor sees, there are tens of patients who are old, confused, angry, hostile, lonely, unable to look after their own welfare in more or less obvious ways, or just plain dumb - and barely able to understand what their problem is, never mind explain it. So it's not an easy profession - not because doctors have to be unusually competent to do it, but because they deal with all kinds of people with all kinds of problems in all kinds of situations, and it's normal for many of those people to be very bad at being able to explain why they're there.

caycep 7y ago

It depends on the culture...I think medical culture differs from place to place. When I was in the northeast, everyone had the ambition of being the next Michael DeBakey or chief of Harvard Medical School, so we'd all run every single test under the sun. The patient'd get a huge bill later from the lab because the insurance didn't want to pay, but what the hey, we were all medical residents and didn't have to deal with the fallout (the primary cares probably did and were pissed). Out here in the west...people will roll in with some obvious diagnosis and some overworked urgent care doc seeing 60 patients a day wouldn't have bothered to ordered even the most basic tests....

busyant 7y ago

Why are you using the word "western" here? Are non-"western" healthcare practitioners exempt from biases and prejudicial opinions? I think it's fair to say that, like all humans, healthcare practitioners may have prejudicial opinions on healthcare matters that can lead to erroneous diagnoses. The western ones don't have a monopoly on this behavior.

tnzn 7y ago
Because this has to do with western medicine as a discipline and practice, in which we over-objectivized health care and the doctor/patient relationship is heavily asymetric. This leads to the fact that in most cases, doctors do not really listen to their patients, let alone believe them when they don't manage to find objective cues of a illness. They easily discard patients' subjective experience. Recent research is calling for a change in that aspect, and change is slowly happening.