Monday, January 28, 2013

The Paranoid Life of Doctors

We've all heard of the medical student syndrome. That's when new medical students start imagining they possess the diseases they are currently studying in medical school. Every student goes through this period of hypochondriasis. You study the chapter on skin diseases and every mole on your body is suggestive of melanoma. Every lump you palpate under your skin becomes a potential lymphoma. After reading about pulmonology, every cough you have suddenly manifests itself as a contagious or cancerous lung ailment. It never fails. After awhile, you learn to brush away those fears as mental and learn to focus on the people who really do have medical issues, the patient in front of you.

At least that's what I thought was supposed to happen. Now that I am into my second decade of practice, these fears of personal medical crises still rear its head. But now I project those fears to my closest family and friends. As a doctor who has seen thousands of patients, I have seen how illnesses can manifest and I can't help seeing them in the people around me.

When my son fell and bumped his head, alarms started going off inside mine. Even though he never lost consciousness, I started thinking about all the worst possibilities. Does he have a subarachnoid hemorrhage? Should I take him to the emergency room? Why is his appetite not as good after the fall as before? Should I wake him up every couple of hours tonight to perform a neuro exam? The paranoia knows no boundaries.

My daughter recently had abdominal pain with nausea and vomiting. There goes the red alerts again. Does she have early appendicitis? Does she need a CT scan of her belly? Maybe she has some sort of bowel obstruction without previous history of abdominal surgery which leads to all kinds of implications? Will my delay in whisking her to the ER cause her to rupture her appendix, develop septic shock, and die? Could I live with that kind of guilt?

Of course both kids were fine. Neither of them had any crippling medical issues. My daughter only had the flu. As for my son, sometimes a bump on the head is just a bump on the head. Those fears were only in my overly educated paranoid brain. It's easy for doctors to dismiss most symptoms that patients complain about because we have seen it all before. Yet by being so jaded we let the occasional Rory Staunton slip through. That's why I am especially on my guard against such carelessness when it's my very own family. But goodness it's not easy to live with.

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