New Lesson

10/25/2010 at 10:55 AM Leave a comment

A month of so ago I saw a middle aged man whose primary complaint was chronic headaches. He had been suffering for many years, more than a decade as he recalls. There were two types, the severe disabling/overwhelming type he would occasionally get, and the basic daily run of the mill headache he had learned to live with.

As you can imagine, this did not promise to be a particularly easy challenge, if I could do anything at all. He had of course been to a panoply of doctors none of whom had accomplished much. He was making one more attempt out of desperation.

I went over the headaches symptoms as usual and all the treatments he had undergone. Unfortunatelly, after that much time and suffering it  is typical for the patient to not fully remember what has transpired. Nevertheless, it seemed to me that a couple of possibilities had not been fully explored. I was clear that eliminating the headaches completely would be unrealistic but that we should be able to reduce their impact on his life.

The next visit was one month later and to our amazement he was better! The severe headaches were gone! the daily ones were much better and easily lived with. Success beyond my expectations! I was tickled. We don’t get many of these successes. Sort of like a hail mary pass working for a TD  in overtime.

The lesson came next. The patient was not nearly as excited as I was. Actually he was not excited at all. I had to ask him several times to confirm that I had heard right, because I thought he should be ecstatic. We continued the treatment and I mulled his reaction (lack thereof) for some time. To be honest I had expected more, perhaps an ‘atta boy’ or something. For a little while I was bummed and confused. Bummed because it was a big deal and I had managed something that many others had not, confused because I have studied human nature for all my life and this did not fit into my five decades of careful study.

It took a long time to finally understand what was happening.

The patient returned and the headaches although not completely relapsed had worsened somewhat requiring tweaking of the medication. Not unexpected  and only slightly disappointing. Even now he was n0t outwardly happy about the significant improvement in his life.

It was weeks later when I was dealing with my Restless Leg Syndrome that I have had for decades that I finally got it! A new treatment completely removed the constant burning I have learned to live with. Absolutely gone! The intense burning was gone and I remember being confused because my feet felt odd. Then it dawned on me that they felt normal!  At that point I was not ecstatic but worried. And that was when I understood my patient. The problem is too overwhelming and too long lived to feel it will simply disapear. Instead the normal reaction is to worry about when it will return. The fact that it will return is not even in question, I presume it will take months for me to consider my foot burning won’t return. And that is what I suspect is going on in my patient’s head.

I look forward to seeing him in a few months and even later to see if indeed he continues to do better and to see when he accepts this as the status quo.


Entry filed under: Doctor Musings, life thoughts, true story.

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