Considering what went wrong to solve a mystery diagnosis
Mysteries, by nature, are intriguing, and health mysteries are no exception. “Diagnosis” is a column in the New York Times Magazine, a book and an original series on Netflix -- all covering medical mysteries and delayed diagnosis.
Dr. Lisa Sanders is a clinician at Yale School of Medicine and author of the popular column and book. She shares some stories of mystery diagnoses with us on “Take Care” this week, including how these kind of diagnoses can make a difference.
“When I first started writing this column in 2002, I wrote it because I thought it was the most interesting story out there -- and I still do,” Sanders said. “I can only say that I guess other people agree with me.”
A mystery diagnosis can have serious impact on a person’s health, but it’s also quite rare. Sometimes, as Sanders points out, the diagnosis is actually for a common health problem, but one that came with unique symptoms.
In “Diagnosis,” in all its shapes and forms, Sanders tells the story of a patient presenting with mystifying symptoms.
“Either mystifying just to the patient or, often, mystifying to a whole string of doctors,” she said.
From there, the story moves to the doctor’s initial diagnosis (or lack of diagnosis) and often details of past diagnoses. It concludes with a proper diagnosis and, in most cases, a happy ending. But simply having a correct diagnosis isn’t the only aim of “Diagnosis.”
“The issue is, in some ways, how mistakes are made and how we figure it out,” Sanders said.
The diagnoses in these stories don’t always come from a doctor. They can come from a nurse practitioner, friend or even the patient themselves. Sanders said this is par for the course.
“Before there was the internet, there was our mother, and our best friend and our spouses,” Sanders said. “Routinely, well before you go to see a doctor, you ask everybody you know ‘Hey, is this something I should be concerned about?’ ‘What do you think this is?’ The internet is just the newest version of how we seek answers when our body isn’t performing the way we’re used to having it perform.”
And that’s not necessarily a bad thing. The internet makes a lot of information available to us. On the other side of the spectrum, it’s not always easy to know where to find trustworthy information on the web. Finding a reliable source is key if you’re relying, even a little bit, on information that you find on the internet.
“I wonder whether diagnosis itself should be a specialty,” Sanders said.
In her writing, Sanders has found that most doctors see most patients because of chronic conditions, rather than acute problems.
“We all know that the person who has seen a disease before is the person most likely to make a diagnosis of something that’s unusual. So I think that maybe making diagnosis itself -- or difficult diagnoses themselves -- an area of specialty might be useful,” Sanders said.