Medical Mysteries: After 18 years, a writer’s insights and farewell (On 'How doctors think' by Jerome Groopman)

https://wapo.st/4iQGkKN


Ask questions, especially ‘What else could this be?’


Doctors increasingly face relentless time pressures, which may facilitate diagnostic errors. Common pitfalls include stereotyping, in which a doctor makes a snap judgment based on negative characteristics, and anchoring, the failure to consider subsequent information that doesn’t jibe with the initial picture. (These and other cognitive pitfalls are deftly explored in “How Doctors Think,” a groundbreaking book by hematologist Jerome Groopman, a professor at Harvard Medical School.)
In more than a half-dozen cases, severe and sometimes lethal physical illnesses went unrecognized for months, sometimes years. Many patients were women who were instead told they had a psychiatric or substance abuse disorder.

 

Definitely had these two a lot. I’m sure the attribution error is unfortunately way too common for ME, especially in the UK.

On the anchoring error: Before I was diagnosed I would often come with my list of dozens of symptoms because I wanted to figure out what was wrong with me. And the physicians would just kind of focus on one or two and ignore the rest. It was really frustrating, no one seemed to want to look at the big picture.

I think this image describes it well

 

It's this horrible attitude that makes all the fake concern about mental illness being just as important as physical health so absurd. We know it's a lie. Those attitudes are very easy to come upon naturally when seeking help, and they are so damn obvious. Most physicians would agree about those, just never about when they apply. You can't take our nose between your fingers. We can't be pacified with hand puppets and a lollypop. Which is about the level of naiveness that it takes to fall for their lies. When they lie to our faces it's a blatant lack of respect, and when we tell them that they condescend even more.

It's truly absurd that this bigotry is never considered a problem. It's wrong. It diminishes medicine and causes far worse outcomes for everyone. We know this. We tell them this. There are studies showing this. They know it. Their attitudes explain this 100%. But still they go around lying to us about mental illness being just as serious. Which isn't even the problem in most cases, which is simply that it's wrong. Wrong category. Wrong set of problems, obviously leading to an invalid set of solutions.

But even without this, those attitudes are just plain wrong. They should not exist, should not be tolerated. A healthy professional culture would not only not have those, it would root them out to prevent them from rising anew. But instead we get this giant mess where they'd rather keep on degrading their profession, instead of improving it. Which is so damn weird, and yet another part of what they speak of us that is 100% pure projection.