Researchers say they can predict who will become "difficult" patient
A Reuters (Sep 15, 1997) report begins
with the following:
Most doctors dread them: difficult patients who
complain of seemingly non-existent illnesses, or refuse to comply with
treatment for the illnesses they do have. Now researchers believe they
can predict which individuals will become 'difficult' patients.
Psychiatrists at the University of Washington in Seattle say that people
who come to physicians "with symptoms that could
not be medically explained" are more likely to be single, therefore
having "diminished social support," and "a psychological
dependency on the medical care system which the physician may perceive
as excessive."
"British physicians have labeled these individuals
as 'heart-sink' patients because when they see the patients' names on their
schedules their hearts sink,"
"The Washington researchers conducted intensive
psychological interviews with 68 female patients in a Seattle rheumatology
clinic. The women, aged 21 to 80 years, complained of either fibromyalgia
or rheumatoid arthritis."
Medicine has a long-standing custom of labeling women hypochondriacs
and persecuting them with "treatments". Remember when PMS was
considered a psychiatric disorder?
"Many doctors may become so frustrated that
they try and curtail or end their relationships with these patients. In
his accompanying editorial on the Washington study, General Hospital Psychiatry
editor-in-chief Dr. Don Lipsitt commiserates, saying "If ever there
was a patient designed to test the mettle and training of a physician,
this must be it."
There are several assumptions in this story. First,
we are expected to accept that psychiatry is a science that can predict
behavior. Of course, psychiatrists have been peddling this nonsense for
years, and have left a trail of victims in their wake. It was just a few
decades ago that official medical dogma was that epileptics should be isolated
from communities since their condition would lead inevitably to criminality.
Here is a quote from the standard text of the 1940s, Cecil's Textbook
of Medicine:
Between attacks, the frank epileptic is usually
a constitutional psychopath of the most disagreeable sort . . . [Epileptics]
are self-centered, unable to grasp the viewpoint of others, and childishly,
uncomprehending when forced to accept the opposite view . . . Like manic-depressives
and other psychotics, they are apt to adjust their depressions through
[alcoholism] and are likewise easy victims of delirium tremens . . .Institutional
treatment properly directed along strictly modern lines affords the best
possible means of handling [epileptics] . . . In properly conducted institutions
the epileptic . . .[is] taught to view his malady in its proper light and
learn to enjoy the inestimable advantages of outdoor life."
(Quoted in "Cruel Compassion: psychiatric control of society's
unwanted," Thomas S. Szasz, 1994, p. 58)
Thus epileptics were "difficult" patients for whom medicine
found a solution: imprisonment in "colonies". Here is how the
medical superintendent of one of the prisons, William E. Sprattling, M.D.,
described his therapies:
Epileptics cannot be cared for successfully, or even with partial success,
in any other way than under the colony plan . . . [The colonies] provide
home life . . . vocations ranging from . . . weeding the cabbage patch
to the making of brick . . . amusements and recreation . . . the highest
treatment for the disease . . . [and] segregating epileptics in colonies
has a too often forgotten value in that it keeps them from reproducing.
(ibid, p. 50)
Even in 1960, a prominent Harvard epilepsy authority was advocating
killing epileptic children:
Epilepsy belong to the specialty of neurology, but the need for custodial
care of public patients has caused epilepsy to be bracketed with the psychoses
in state departments of mental disease and in the American Psychiatric
Association . . . Society systematically and cruelly kills its best members
by the means called "war," and unmercifully prolongs the lives
of its hopeless liabilities [idiotic epileptic children].
(ibid,
p. 60)
This predictive claim of the University of Washington psychiatrists
brings to mind the sharp sarcasm of Karl Kraus, who noted that "The
psychiatrist unfailingly recognizes the madman by his excited behavior
on being incarcerated."
Of course, the psychiatrist of today is much more progressive. He recognizes
mental illness in children who misbehave and women who complain of joint
pain. No need to worry about imprisonment, though, since we now have Ritalin
and Prozac.
If you value your liberty, you will politely excuse yourself the next
time you seek help for an unexplained symptom and are asked if you are
single and unhappy. Misery may love company, but your doctor does not want
that company to be him.
Another assumption in the story is that science knows all there is to know about ailments, therefore all "unexplained symptoms" are psychosomatic. This widely prevalent anti-scientific, anti-intellectual view among physicians has a name: dogma. It is this medical dogma that still has physicians resisting properly treating ulcers as a bacterial infection rather than a "stress disorder." Anyone with access to the internet can read of an almost daily discovery which overturns the existing understanding of a disease or its treatment. Science is not the ally of dogma, yet physicians, ostensibly scientists, often retreat to the secure confines of dogmatism. The hardest thing for a physician to say is "I don't know. Let's see what we can learn together." There is no "together" since the "patient,"--itself a dehumanizing title (when did you stop becoming a person and become a "patient"?)-- is often merely an inferior to be acted upon, not an equal to be respected.
See also:
Study says Hispanics
and blacks less likely to receive proper pain control
Fear of doctor visit elevates blood pressure
for some
Hospital
study: half the patients experienced treatment errors
AiA Home
Site Contents
News from medicine
American Iatrogenic Association
2513 S. Gessner, #232
Houston, Texas 77063
www.iatrogenic.org
aia@iatrogenic.org