WWWWF:Good stuff
Advice for patients and just neat stuff
Groopman gives some good advice for patients about fending off stereotyping docs.
Rather, Delgado believes, patients and their families should be aware that a doctor relies on pattern recognition in his work and, understandably, draws on stereotypes to make decisions. With that knowledge, they can help him avoid attribution errors.
"It's not easy for laypeople to do," Delgado said, "because patients and their families are especially reluctant to question a doctor's thinking when their questioning suggests his thinking is colored by personal prejudice or bias." Still, Delgado thinks laypeople can diplomatically direct a doctor's attention to his reliance on stereotypes, because on of her patiets had done this with her.
That brings us to the neat stuff, namely just how fascinatingly weird the human body is. The patient that talked to Delgado was Ellen Barnett.
Ellen Barnett had already consulted five physicians and felt all five had shunned her. "I'm having what I call explosions, feeling hot all over, which make my skin crawl. I mean really crawl, like ants all over, and sometimes they come with terrible headaches," she told Delgado. "Really, it's like a bomb going off in my body. I know I am in menopause, and all five doctors told me that that's the cause of my problems. And two told me that I'm crazy. And, frankly, I am a little crazy."
That kind of candor helped the doc overlook the obvious menopause diagnosis and uncover the neat biology:
"I evaluated her very extensively," Delgado said, "and it turned out that, yes, she was menopausal, and yes, she was a strange person with lots of weird ideas, but what turned up in her urine was not from menopause or being kooky. Her catecholamine levels were through the roof. A CT scan showed a pheochromocytoma above her left kidney."A pheochromocytoma is a relatively rare endocrine tumor that produces catecholamine, chemicals like adrenaline that can cause wild swings in blood flow and blood pressure. The changes in circulation may mimic menopausal hot flashes and precipitate severe migraine-like headaches. The catecholamines can also cause psychological symptoms such as anxiety, despair and even aggression. If untreated, the patient may have a stroke or heart or kidney failure.