Maybe it’s a Southern thing.  Maybe it’s a human thing.  But I’m always amazed at this little interaction:

45-year-old man comes to the emergency department with severe abdominal pain.  Receives immediate triage to the patient care area.  He receives rapid IV access and narcotic medication for his pain.  Hundreds of dollars of lab work are drawn, and an EKG is obtained just to be on the safe side.  CT scan of the abdomen and pelvis, with oral and IV contrast is also obtained.

In the end, his pain is resolved, his vital signs are normal (as they were at the outset), his labs are normal and his CT is unrevealing.  A gall bladder ultrasound is done as an afterthought and is also normal.

‘Mr. Adkins, I think we can let you go home.  Your pain is gone, and there is no obvious finding to suggest its source.  I’m happy to report no appendicitis, no abscess, no diverticulitis, no aneurysm, no perforated ulcer, no gall-bladder disease.  Maybe it was gas.  Who knows?  But you’re fine.’

He appears surly.  ‘You mean to tell me I come down here to this ER and you’re telling me there ain’t nothing wrong?  I wasted all my time for you to tell me that?  I’m here with pain and you ain’t done nothing and you’re telling me to go home?  Well that’s just crap.  I’m telling you something is wrong and I’d appreciate it if someone would try and figure it out.’

Something is going on in this little scenario that I can’t quite figure out.  Maybe, Mr. Adkins was comatose while we treated his pain and spent thousands of dollars looking.  Maybe, Mr. Adkins wants desperately to be sick and to therefore validate his general unhappiness.  Maybe, he wants a reason for more pain medication.  Maybe, he’s just looking for a fight.  But whatever the reason, I see it more often than I’d like.

Many people are just simply disappointed when they learn that nothing is wrong.  In a society that is over-medicated and over-medical, in a culture in which we have made a priesthood of health and a sacrament of lab tests and radiographs, in a time when sickness is as much an identity as an affliction, being told you’re well is like being excluded from a club.

Even parents, rather than saying ‘Yeah!  My child is well!’ sometimes wander off and complain that we ‘didn’t do anything.’  And seem disappointed that we ‘wasted their time to tell them nothing was wrong!’  Would they feel better if we diagnosed cancer?

The desire to be sick, and the disappointment at wellness, is a unique phenomenon of modern medicine, to be sure.  I think I’ll call it ‘Leap Syndrome.’

Have a great, healthy day!

Edwin Leap

0 0 vote
Article Rating