I swear I didn’t make up the story I am about to relate. I was able to follow it step by step because it happened to a woman I know well (but who would like to remain unidentified for Internet purposes). Anyway, this woman, in her 60s, suddenly began experiencing abdominal pains and much fatigue in early August. She visited her primary care physician, who speculated she might have kidney stones. He sent her for a CAT scan, which came back normal. She felt better for several days, so he speculated she passed a stone and would be okay.
Another similar attack a couple weeks later. Another visit to the physician. Possibly gall stones, he speculated. An ultrasound test, which again showed everything normal. So now he began to take off the gloves. He scheduled a series of gastro-intestinal tests, and a visit to a gastro-intestinal specialist.
In the meantime, the attacks were coming more frequently. Severe abdominal and chest pains, accompanied by fatigue–all enough to drive her to bed for a day or two at a time. As you might imagine, not only was there much physical pain, but huge amounts of the anxiety that comes from knowing you are sick, but not knowing what’s wrong. She imagined all kinds of cancer.
At the end of August, I finally convinced the woman to visit an acupuncturist I have used, simply to try to gain some relief from the intense pain. She resisted. Not only was she skeptical about what an acupuncturist can accomplish, but she wanted to complete the physician’s recommended tests and specialist consults.
Finally she relented–okay, one visit. In treating her, the acupuncturist noticed a small rash on the woman’s upper abdomen. Shingles, the acupuncturist said. You have shingles. (Simply defined, shingles is an adult version of chicken pox, characterized by rashes and much pain.)
Later that day, the woman visited her health center, and met with the physician on duty (not her regular internist). He confirmed the shingles diagnosis, and even had a laugh about it–"What till I tell (your internist) about this." Presumably he was referring to the fact that an acupuncturist diagnosed in a few minutes what his colleague and his fancy tests couldn’t diagnose in a month. He then put the woman on some anti-viral medication. She is gradually getting better physicially, perhaps in part because she is so relieved to know she doesn’t have a terminal illness.
The moral of the story? Actually, I think there are a few morals. First, don’t expect super diagnostic skills from most physicians. Second, and related, physicians lean heavily on all the high-tech tests at their beck-and-call mainly as insurance to guard them against a major snafu. In so doing, they may fail to tend to such basics as asking simple questions and conducting a thorough physical exam. (In this case, the physician examined the woman the first time she came in, when the rash might not have yet appeared, but never did another exam in subsequent visits.) And third, it sometimes helps to get an outside opionion, as in outside the conventional system.
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