Fuck you every doctor who told me my digestive problems were in my head or my fault for being a bad patient and you couldn’t help me until I solved the problem that drove me to you. You were factually incorrect and you should feel terrible.
I sympathize so much with this and other sections of this post.
Here’s a somewhat related story of my own.
Part 1
I developed sudden strong stomach cramps in 2017, and while I did get a relatively quick appointment for an endoscopy, it was still a few weeks of suffering. In the meantime I was told that my problem was likely work-related stress or something. And it ultimately turned out to have been work-related stresshelicobacter pylori, a stomach bacterium for which there is a well-known treatment (taking two different antibiotics and a proton pump inhibitor) which worked quickly and completely.
Side note: Supposedly a significant chunk of the developing world has this bacterium. (Wikipedia: “In 2015, it was estimated that over 50% of the world’s population had H. pylori in their upper gastrointestinal tracts[6] with this infection (or colonization) being more common in developing countries.”) But if that’s true, the vast majority of cases must be asymptomatic or mild; the world presumably doesn’t look like debilitating stomach issues are anywhere near that common.
Part 2
Around two years later, I again experienced stomach cramps. I figured that I was well-prepared this time, knew exactly what the problem was, and how to get rid of it. Unfortunately, this time I tested negative for helicobacter and other obvious problems, so I had no idea what to do. (Helpful diagnoses included stuff like irritable bowel syndrome, which essentially means “we don’t know what’s wrong with you, but we still needed a label to bill health insurance”.) My stomach issues lasted for months and got worse until a strategy eventually worked (probably probiotics, maybe assisted by removing lactose from my diet; I never entirely found out).
Also unfortunately, the beginning of my new stomach issues coincided with visiting some new mental health professionals for unrelated reasons. Several of them were all but convinced that my problems were psychosomatic. Again, infuriating and unhelpful. But not surprising—if all you have is a hammer (i.e. a therapist can’t diagnose stomach problems), then everything looks like a nail (i.e. psychosomatic).
And none of those doctors will have or could have learned anything from this episode. After all, it’s not like there’s any feedback channel that would have informed them that their hypothesis was wrong.
The cool thing about the “psychosomatic” diagnosis from the doctor’s perspective is that it is a convenient, utterly non-disprovable “diagnosis” that offers closure to the doctor: “I found out what is wrong with the guy” instead of admitting failure: “Well, there is a problem but I don’t know what it is.” It also sends the patient on a long (month to years) therapy loop which offers plenty of time for the problem to resolve on it’s own (which happens frequently). An additional perk is that any question or doubt of the patient can be chalked up to “being defensive / in denial” or “uncooperative” which is of course a symptom of the underlying psychopathology.
Yes. My uncle, who is a doctor working in gastroenterology, was talking about basically the exact same topic last week. He said that they’re highly confident a significant number of patients are having entirely or near-entirely psychosomatic illnesses, but it’s incredibly difficult to identify when that is specifically happening, and unfortunately due to time and money constraints they have a tendency to just slap the label on difficult cases. We just do not know enough about the human body and how the brain affects it to be confident outside of extremely obvious cases. Even a lot of what we do know is being reexamined in the last two decades due to edge cases being discovered and lack of rigor in earlier testing.
Sure, absolutely, poor mental health worsens physical health, and some debilitating condition have no apparent physical causes.
But this doesn’t make them hurt less. It doesn’t provide a resolution.
My episode beginings have a significant correlation with stressful events. I am perfectly aware of this. I would still, really really, like a way to interrupt the resulting destructive cascade other than going “well, it would have been better not to have been stressed”.
I sympathize so much with this and other sections of this post.
Here’s a somewhat related story of my own.
Part 1
I developed sudden strong stomach cramps in 2017, and while I did get a relatively quick appointment for an endoscopy, it was still a few weeks of suffering. In the meantime I was told that my problem was likely work-related stress or something. And it ultimately turned out to have been
work-related stresshelicobacter pylori, a stomach bacterium for which there is a well-known treatment (taking two different antibiotics and a proton pump inhibitor) which worked quickly and completely.Side note: Supposedly a significant chunk of the developing world has this bacterium. (Wikipedia: “In 2015, it was estimated that over 50% of the world’s population had H. pylori in their upper gastrointestinal tracts[6] with this infection (or colonization) being more common in developing countries.”) But if that’s true, the vast majority of cases must be asymptomatic or mild; the world presumably doesn’t look like debilitating stomach issues are anywhere near that common.
Part 2
Around two years later, I again experienced stomach cramps. I figured that I was well-prepared this time, knew exactly what the problem was, and how to get rid of it. Unfortunately, this time I tested negative for helicobacter and other obvious problems, so I had no idea what to do. (Helpful diagnoses included stuff like irritable bowel syndrome, which essentially means “we don’t know what’s wrong with you, but we still needed a label to bill health insurance”.) My stomach issues lasted for months and got worse until a strategy eventually worked (probably probiotics, maybe assisted by removing lactose from my diet; I never entirely found out).
Also unfortunately, the beginning of my new stomach issues coincided with visiting some new mental health professionals for unrelated reasons. Several of them were all but convinced that my problems were psychosomatic. Again, infuriating and unhelpful. But not surprising—if all you have is a hammer (i.e. a therapist can’t diagnose stomach problems), then everything looks like a nail (i.e. psychosomatic).
And none of those doctors will have or could have learned anything from this episode. After all, it’s not like there’s any feedback channel that would have informed them that their hypothesis was wrong.
The cool thing about the “psychosomatic” diagnosis from the doctor’s perspective is that it is a convenient, utterly non-disprovable “diagnosis” that offers closure to the doctor: “I found out what is wrong with the guy” instead of admitting failure: “Well, there is a problem but I don’t know what it is.” It also sends the patient on a long (month to years) therapy loop which offers plenty of time for the problem to resolve on it’s own (which happens frequently). An additional perk is that any question or doubt of the patient can be chalked up to “being defensive / in denial” or “uncooperative” which is of course a symptom of the underlying psychopathology.
Yes. My uncle, who is a doctor working in gastroenterology, was talking about basically the exact same topic last week. He said that they’re highly confident a significant number of patients are having entirely or near-entirely psychosomatic illnesses, but it’s incredibly difficult to identify when that is specifically happening, and unfortunately due to time and money constraints they have a tendency to just slap the label on difficult cases. We just do not know enough about the human body and how the brain affects it to be confident outside of extremely obvious cases. Even a lot of what we do know is being reexamined in the last two decades due to edge cases being discovered and lack of rigor in earlier testing.
That label also just does not achieve anything.
Sure, absolutely, poor mental health worsens physical health, and some debilitating condition have no apparent physical causes.
But this doesn’t make them hurt less. It doesn’t provide a resolution.
My episode beginings have a significant correlation with stressful events. I am perfectly aware of this. I would still, really really, like a way to interrupt the resulting destructive cascade other than going “well, it would have been better not to have been stressed”.