Tuesday, September 15, 2009

Medical training vs common sense

I'm a patient again. Much like what happened sometime in 2007, a random tiny scratch to the surface of my skin blew up into a cellulitis over my right jaw and temple that has me looking half as round-headed as Charlie Brown. I had a perfectly normal yearly checkup on Friday, and by Sunday night was febrile and wracked with chills.

Being relatively smart, I went to Urgent Care Sunday afternoon, so I was already downing antibiotics, and I was sure that this infection was unrelated to a minor surgical thing I had done to my right cheek earlier in the day on Friday. Nonetheless, I thought it courteous to let the Derm Surgery people know I was blowing up, and taking antibiotics. Naturally enough, they wanted to see me again today.

It was a silly visit, all in all, but I kept reflecting that if I were the provider rather than the patient, I'd want that patient to come in. The surgeon nodded, listened, looked, and agreed that I was doing all I could, or should. Then I mentioned that maybe I'd start warm compresses a few times a day, just to help the lymphatics drain. And he said something I think is incidentally hilarious:

"Well, that's just symptomatic relief."

I mean, we just got done talking about my regimen of two antibiotics. It's not like I gave any indication that a hot washrag is my idea of a cure. Also, he knows I'm a PA.

So I said "well, yeah," when inwardly what I meant was "no shit, it's just that my awareness that there are bacteria isn't what's making my face hurt, and while I wait for them to die I'd like to control the symptoms." Symptoms are by definition those things that are bugging the patient. Relieving them seems like it might be worthwhile.

I know what he meant -- controlling symptoms is not the same thing as treating a condition, and things that make you feel better don't necessarily make you better. But it's clearly such a reflexive thing for this guy to say, and he must have said it so many times, it just struck me as funny.


Rabrab said...

Febrifuge, if you don't already know about these guys, you need to: http://www.laryngospasms.com/fr_index.cfm (Be warned, the website has sound, but there's a volume slider at the bottom of the page.

Febrifuge said...

In an article I was reading, somebody quoted a Dana Gould bit about this. Some alternative practitioner gives Gould crap about a med he's taking, as it "just masks the symptoms, but doesn't treat the real problem." He says "that's why I own a coat. It's still cold out, but the coat keeps me from feeling it."

Rab, thanks for the link. I actually learned about the 'Spasms from a dotty SICU nurse when she learned I was from Minneapolis. She photocopied the lyrics for me and everything.