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.

2 comments:

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.