WWWWF:
A Look at Wichita Falls on the Web

Chapter 7 relates Dr. Groopman's problems in finding a hand surgeon to diagnose his problems after his hand began to ache and swell. After a while I just realized how often I wrote "Yeesh!" from being dumbfounded by the revelations. From the start, his ordeal seems ridiculous

Over the course of three years, the patient had consulted six hand surgeons and got four different opinions about what was wrong and what to do about it. I was that patient.

But the hits keep coming. For instance, with the makeup of our bodies

"Often we don't know what accounts for symptoms of pain in the hand, given that almost everyone has a hole in a bone if you look hard enough."

Or the necessity of operations.

Dr. B studied in detail every unusual shadow and shape on my x-rays and MRI scan. In addition to the cysts in the scaphoid and lunate bones, he noted a tiny cyst in the another bone, on the pinkie side of the wrist. The tendon that runs toward the pinkie also seemed to have slipped slightly out of position. Dr. B thought there was a hairline fracture in the scaphoid bone, not simply a cyst. He said that I needed three surgeries. ...

Dr. Terry Light said, of course, that to comment properly on Dr. B's opinion, he would hae had to examine me and view the MRI; but the idea of three surgeries to address every finding on the scan -- this gave Light pause. "That's the problem with MRI. It can show us way too much."

My favorite is the guy who just makes something up.

At each follow-up visit, I pressed Dr. A for answers. He would just shrug. Then, a year after I first consulted him, he said, "I think you have developed a hyperactive synovium." The synovium, the lining of the joints around the wrist and hand, Dr. A explained, had become too sensitive to endure even minor stresses. It overreacted by becoming inflamed. He suggested a surgical procedure to strip away all of it. ...

I am not a specialist in diseases of the ones and joints, and I'd never heard of a "hyperactive synovium." Niether had Dr. Light: he said that the diagnosis "didn't register. It doesn't really mean anything to me.

Dr. A had come to the end of his thinking. But instead of returning to the honesty of "I really don't know," he invented something to respond to my plaintive questioning and suggested an operation that could be damaging.

The remedy is to get someone else in the room to bounce ideas off of. Groopman took his wife.

Pam had been quiet, communicating through glances with me. As I read the paper, she began to question the resident, politely but pointedly. She wanted to know how long the procedure took, what the likelihood of each complication was -- not just a list of possible complications -- and how long it took to recover.

All of it made me come up with a new company idea: Medical Buddies. Get a group of retired nurses, nurses assistants, etc., and hire them on a contract basis to just accompany folks on visits to the doctor when they think something serious is in the offing. That way, a lot of the questions a medical professional might have can be used to benefit a patient.

The alternative -- i.e., the here and now -- is just frightening to contemplate.