The Physician’s Fallacy

We could not get along in today’s world without physicians. That’s pretty much a given. I would not still be here were it not for some really fine trauma doctors.  But …

There is a limit to what physicians can do and that limit is that they are human. They are subject to all the foibles and follies that the rest of us are. They are opinionated, biased, hidebound, blind and sometimes just plain stupid.

It is their job to diagnose what is wrong with us. Sometimes it is cut and dried. There are tests that are specific. Results that can be interpreted only one way. Other times, there are no definitive tests and interpreting the results is a matter of opinion and feelings. A doctor might say to you, “I think that what you have is polymyalgia rheumatica. There is no test for it. There is no cure. The treatment to manage the symptoms is steroids.” The important takeaway is this, the doctor does not really know for sure and that doctor is going to experiment on you by having you take a drug and then looking at the results. If the drug helps, then that doctor will most likely think that they were correct. If it does not, then it is time to maybe run some more tests and then experiment with a different drug.

We go to physicians for healing and to get well. But for the most part, all that happens is that they put a patch on the problem. For some people, that patch leads to other problems. Think of a dam that is failing. You have a spot where the water is leaking out, so you put some extra concrete on that spot. But the whole dam is not in the best shape, so water starts leaking in a new spot. So you patch that area and then a leak stars in another place until the whole thing is so messed up that it fails completely.

Some people have good experiences with physicians throughout their lives. Some people have a mix. And some people have nothing but trouble. For the latter group, trusting physicians can be difficult.

I fall into that latter group. Throughout my life, when I have gone to a doctor for one problem, I’ve ended up with several more and not always found a fix for the original problem. It is not directly the physician’s fault. I have a very sensitive body and tend to get every drug’s side effects. But it is indirectly the physician’s fault for not listening to me when I explain about my sensitivities and ask for help other than drugs. Handing me a prescription and having me go away is so much easier than actually helping me to overcome what is wrong.

I had migraine headaches every day for a little over four years. I did not get the classic migraine with the aura that alerts you it is on the way, then lasts a few days, goes away, and then you do not get another one for a month or so. I had two on most days. One in the morning and one in the afternoon with a couple of hours in between where I could wash my face, brush my teeth, eat a little something, do the dishes, start some laundry … have a life more or less, in two or so hours a day. The rest of the time, I was flat on my back, in a darkened room, hoping the neighbors would not be too noisy.

About two years into the whole mess, I saw a neurologist. He did an exam and a long interview. It took about an hour and a half. At the end of it, my afternoon migraine had started and I was feeling awful. He said to me, “You definitely have migraine headaches. You are having one right now, aren’t you?” I told him that yes I was. Then he said, “Dianne, what is it that you want me to do?” I said, “I want you to help me to figure out why I get migraines and what I need to do to stop getting them.” He said, “Dianne, you get migraines because you get migraines. There are a couple of drugs we can try.”

That was not what I wanted. He did not even consider trying to help me to accomplish my goal. He thought he knew what the only answer was. He was not going to look beyond his beliefs.

He talked me into trying the first anti-hypertensive that was ever developed. But I told him that I didn’t think it was a good idea. My blood pressure was already on the low side and my heart rate was slow for someone my size. But he said it was a very low dose and had worked as a preventative for migraines for a lot of people. I was desperate so I relented. But doctors are generalists. They look at populations and extrapolate to individuals. They think they know all that they need to know, but they often do not. And an individual is just that … individual.

Within a couple of days of taking the drug, I could not walk from the living room to the kitchen without taking a break in between. When standing from sitting, I would nearly pass out and usually fell back into the chair no matter how carefully or slowly I stood up. I could no longer make use of my couple hours free of migraine headaches during the day. My life became even more constricted than it was already and it did nothing to relieve my migraine headaches.

I tried the drug for a couple of weeks because the neurologist said that I should give it at least that much time and that it would get better. But it never did. So I tapered off of the drug and went to see him again for my follow up. Then, stupidly, I let him talk me into trying another drug that had helped other migraine sufferers. This time it was an antidepressant. Again, I was desperate so I gave it a try.

I got every side effect in the book. I had insomnia. When I did sleep, I had terrible nightmares. I had waking nightmares. I might be doing the dishes and I would see horrible things that looked so real I would go into a full on panic. Every muscle in my body twitched. Constantly.

After several weeks and no relief from my migraine headaches, I had had it. I hiked out into the forest near our home. I went as far out as I could. I took my gun. I was going to end it all. I wrote my note. I put it in a plastic bag and duct taped it to my thigh under my jeans. I put the gun to my head.

Then I thought, as miserable as I was and as much as I wanted to die, I couldn’t do that to my husband. I remembered a woman I knew who had killed herself and how devastated we all were by that. And during that pause, I also remembered that suicide is a side effect of antidepressants and I decided I was not going to let some damn drug kill me.

I tapered off of the antidepressant and never went back to the neurologist. That whole experience cemented my distrust of physicians and set the stage for the rest of my life.

There are many more instances of doctors hurting me more than helping me over the years preceding my experience with the neurologist. But that one experience is the best example of what I am trying to say. They do not really help. It is rare that they actually help. Mostly they just patch the problem rather than getting to the root of it.

So once I was off the antidepressant, I went to the library when I could manage it. I researched headaches in general and migraines in particular. I learned about food triggers and environmental triggers. I read about elimination diets and food challenges.

It took me about two years, but I found all the things I should not eat. I found all the things I should not expose myself to. I got to the point where I was having only four or five migraine headaches a week. Then I found a biofeedback therapist that helped me get rid of the rest of them by learning how to warm my hands and relax the muscles in my neck and shoulders.

I did just what I had asked that neurologist to help me do … I figured out why I got migraine headaches and what I had to do to stop getting them.

Most physicians approach the human body as if it is a closed system full of all sorts of other closed systems. But it is not a machine. It is a finely tuned thing, sensitive to everything around it. It takes in air filled with all sorts of chemicals and gases. It absorbs things through the skin and gums. We eat all sorts of things with all sorts of chemical constituents. You cannot look at any one part of it and say, “This will fix this.” Because whatever you do to one part, affects every other part. Sometimes negatively.

There is a holistic movement. It has been gaining momentum. But in most cases, you will be told it is not meant to take the place of traditional medical care. And I am sure that is valid for a great many people. But until holistic health is taught in all the medical schools and until all physicians and healthcare providers of every sort everywhere embrace the concept and accept it and implement it, people like me are going to suffer.

I am an extreme case in point (although studies show that most prescription drugs have their intended effect in only about one third of the population), but I do not believe that other people are less affected. I think that they are simply less aware. Do you get a headache when you walk into certain stores or buildings? Do you wonder why? Or do you take a pain reliever and go about your day? How many pain relievers do you take and how often do you take them? They have side effects too. Stomach troubles are common to a lot of them. Are you also taking an acid reducer on a regular basis? Have you asked yourself why you might need an acid reducer?

The fallacy is that we assume doctors are going to heal us. For the most part, they do not. We heal ourselves. You get a throat infection. You go to the doctor and you get a prescription for an antibiotic. You take it for ten days. You have diarrhea and some other discomforts, but at the end of the ten days, you are basically over the throat infection. Also consider, you get a throat infection. You do not go to the doctor. You do not get an antibiotic. You do not have diarrhea and a few other attendant discomforts. And in about 14 days, you are over your throat infection. So, yes, it took four days longer. But you didn’t destroy your intestinal bacteria in the process. And it is being shown today that the health of the bacteria in your intestines is directly related to the health of multiple organ systems in the body. Yes, I know there is MRSA and other resistant bacteria and those definitely need some strong antibiotics. But regular illnesses often do not need intervention.

Yes, when you need an operation to fix a defect like a hernia or an artery that is severed or to remove some really bad hemorrhoids, a surgeon is a good thing to have around. And they do fix the problem. But they still do not heal you. You do that. And in that last case, does the physician talk to you about why you got them in the first place? Do they question your diet? Or your exercise regimen? Do they work with you to create a life in which hemorrhoids do not happen? In my experience the answer is going to generally be no. But if yours does, that’s great and a step in the right direction.

Nothing much will change until we all begin demanding that things change. We need to demand better and more complete care. We need to demand that doctors actually listen to us and what we know to be true about our bodies.  

One last short story. My mom had pain in various parts of her body for a lot of years. Mostly, it was in her shoulders. Our family doctor kept telling her it was bursitis and recommended aspirin. She kept telling him it was something more. She felt there was something fundamentally not right with her body. Our doctor wrote it off as the maundering of a woman who had more than once displayed hypochondriacal tendencies.  As a result, she was not diagnosed with lupus until the disease had a death grip on her.

No matter how much they know … and yes, they know a lot … they still do not know our bodies as well as we know our bodies. They need to drop their preconceptions and be open to what we think is going on inside of us. They need to listen.

They need to start really healing.