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It's Not All In Your Head

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Re: It's Not All In Your Head

#61

Post by InfiniteRand »

bena wrote: post #51
smeej wrote: post #26

I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I've had tell me, explicitly, within 15 minutes of having met me that they know my body, symptoms, and experience better than I do. It used to come much later in the process, after I'd spent months following their instructions to the letter and having my symptoms…

But on the flip side of this, you don't know your internal workings better than they do. Just because you live in your body doesn't mean you know how it works. I drive a Civic, it doesn't make me a mechanic. Diagnosis is tricky. Especially in a system as complicated and interconnected as the human body. People often have a bad tendency to misattribute effects to recent events. And let's say your conjecture of why the…

I’m not sure if the work is the same either way (I feel ambivalent on this question). If you know that no diagnosis is possible you have to simply alleviate the symptoms as best is possible (I wish therapy was thought more of in this way, maybe it’s not all in your head but we can’t figure it out so let’s help you deal with it), if there is a possible silver bullet you need to keep chasing that even if that chasing increases the symptoms.

But thinking this over that’s a false dichotomy, even if your doctors have exhausted their theories it doesn’t mean that some other doctor might not have an idea or there’s some variation on one of the existing theories that might explain things.

Likewise, even if an exact diagnosis is found, few treatments are 100% effective in all cases, and most diagnosis have special cases which complicate things in sometimes baffling ways.

Realistically, people usually need to both address symptoms directly and seek underlying causes to some degree when dealing with illness. That exact degree depends on the exact situation but it’s typically not 0% in either case.

I would add something else, ultimately, especially with vague complicated symptoms which occur both in firmly physiological and firmly psychological disorders, the primary goal is typically to return function to ones life. Whether or not the mechanism to do so is real or not is of secondary importance especially if it doesn’t cause much harm relative to its benefit (which is not a simple matter to evaluate in cases like long term antibiotics for chronic pain, but I think is easier to evaluate for things like exercise (it might not cure the underlying cause, but it is likely to be indirectly helpful and unlikely to harmful so…))

Re: It's Not All In Your Head

#62

Post by makeitdouble »

raziel2p wrote: post #38
smeej wrote: post #26

I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I've had tell me, explicitly, within 15 minutes of having met me that they know my body, symptoms, and experience better than I do. It used to come much later in the process, after I'd spent months following their instructions to the letter and having my symptoms…

I think it's too much to ask that every doctor (or any professional in any field, really) make an accurate individual judgement on who of their clients are able to do their own research or not. That's a luxury you might be able to afford if you're offering high-end (and thus expensive) services, but not when serving a large amount of customers.

The issue is we’re not “customers”, it’s a regulated profession so you don’t get to pick and choose ad infinitum, and it’s also not like you could bypass them and directly receive treatments you think you need.

If you’ve done your homework when coming to them, I don’t think it’s too much to expect to have them at least pay attention to what you bring to the table.

Re: It's Not All In Your Head

#63

Post by dec0dedab0de »

smeej wrote: post #26

I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I've had tell me, explicitly, within 15 minutes of having met me that they know my body, symptoms, and experience better than I do. It used to come much later in the process, after I'd spent months following their instructions to the letter and having my symptoms…

But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me.

I agree, but this has happened less and less as I have gotten older. I'm not sure if there is newer training, or they just give me the benefit of the doubt because I'm a decade older than them. Either way, I have found that older doctors are more likely to talk down to me, even when they clearly do not know what they're talking about.

Re: It's Not All In Your Head

#64

Post by Madmallard »

A huge issue with doctor patient relationships in 2021 is that modern health conditions that heavily lack research are exploding in incidence. Take patients with allergic presentations and intolerances that don't register with IgE testing. I know probably two dozen people with this issue, including myself. The immunologist and PCP can recognize what's going on as a problematic immune response but cannot explain the origin from current lab findings. Imagine the frustration and difficulty.

Re: It's Not All In Your Head

#65

Post by thegrasshopper2 »

bena wrote: post #51
smeej wrote: post #26

I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I've had tell me, explicitly, within 15 minutes of having met me that they know my body, symptoms, and experience better than I do. It used to come much later in the process, after I'd spent months following their instructions to the letter and having my symptoms…

But on the flip side of this, you don't know your internal workings better than they do. Just because you live in your body doesn't mean you know how it works. I drive a Civic, it doesn't make me a mechanic. Diagnosis is tricky. Especially in a system as complicated and interconnected as the human body. People often have a bad tendency to misattribute effects to recent events. And let's say your conjecture of why the…

True, but you know which noises are normal for your Civic much better than your new mechanic (or even your old one). If you know there's a new sound, your mechanic has to take that as truth and find the (a) problem. Works the same for a body.

Incidentally this problem is what is stopping me from going to a doctor right now. I'm having headaches recently which are not normal for me, but are still in the realm of "normal". I'm putting off a visit to the doctor because I'm afraid they'll say it's normal. It is not, for me.

Also, always search a second opinion. I wouldn't be born if my parents went for the "absolute truth" of the doctor they had at the time.

Re: It's Not All In Your Head

#66

Post by mistermann »

bena wrote: post #59
mistermann wrote: post #56

Earlier quoted context omitted.

> Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor. This seems more truthy than True.

It may be an exaggeration for effect, but in any walk-in clinic, you're going to get at least one of those a day.

"at least one of those a day" sounds like a vast minority rather than "everyone" though doesn't it?

Re: It's Not All In Your Head

#67

Post by didericis »

dec0dedab0de wrote: post #63
smeej wrote: post #26

I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I've had tell me, explicitly, within 15 minutes of having met me that they know my body, symptoms, and experience better than I do. It used to come much later in the process, after I'd spent months following their instructions to the letter and having my symptoms…

But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. I agree, but this has happened less and less as I have gotten older. I'm not sure if there is newer training, or they just give me the benefit of the doubt because I'm a decade older than them…

This is an overgeneralization, but I’ve experienced this most often with affluent baby boomers, across all disciplines. I don’t think it’s purely an age gap issue, as I generally don’t get that sense from generations older than baby boomers. It could have less to do with your age and more to do with baby boomers aging out of the workforce.

The most arrogant and least approachable managers, teachers, doctors, etc I’ve encountered always seem to be from that generation.

Maybe I’m just a “spoiled millennial”… this kind of generational generalization is almost definitely unproductive, but I can’t help myself from thinking it has some validity.

Re: It's Not All In Your Head

#68

Post by bena »

mistermann wrote: post #66
bena wrote: post #59

Earlier quoted context omitted.

It may be an exaggeration for effect, but in any walk-in clinic, you're going to get at least one of those a day.

"at least one of those a day" sounds like a vast minority rather than "everyone" though doesn't it?

That's why we call it an exaggeration for effect.

Re: It's Not All In Your Head

#69

Post by bena »

RobertRoberts wrote: post #60
bena wrote: post #51

Earlier quoted context omitted.

But on the flip side of this, you don't know your internal workings better than they do. Just because you live in your body doesn't mean you know how it works. I drive a Civic, it doesn't make me a mechanic. Diagnosis is tricky. Especially in a system as complicated and interconnected as the human body. People often have a bad tendency to misattribute effects to recent events. And let's say your conjecture of why the…

An old guy once told me how veterinarians were often better doctors than medical doctors because their patients couldn't confuse the diagnosis with bad input. But, I've also met simply belligerent doctors before, that simply couldn't be wrong no matter what the evidence said... There's human error on both sides to take into account.

Which is really my point here.

The person I responded to is laying the fault completely with doctors. But doctors see patients like him all the time. And they're often wrong.

The cases where they're not wrong is survivorship bias at work. It makes "patient knows better than doctor" feel more common than it is.

Re: It's Not All In Your Head

#70

Post by raziel2p »

makeitdouble wrote: post #62
raziel2p wrote: post #38

Earlier quoted context omitted.

I think it's too much to ask that every doctor (or any professional in any field, really) make an accurate individual judgement on who of their clients are able to do their own research or not. That's a luxury you might be able to afford if you're offering high-end (and thus expensive) services, but not when serving a large amount of customers.

The issue is we’re not “customers”, it’s a regulated profession so you don’t get to pick and choose ad infinitum, and it’s also not like you could bypass them and directly receive treatments you think you need. If you’ve done your homework when coming to them, I don’t think it’s too much to expect to have them at least pay attention to what you bring to the table.

I think it is, actually - especially if 90% of people who "do their homework" actually end up with the wrong conclusions, and 50% of those are too stubborn to admit that they are wrong. It can be a massive waste of trained professionals' time.
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