I went from slim to thin to emaciated. The pain got worse, a white heat in my belly that made me double up unexpectedly in public and in private."
Trying to find the answer, I saw doctors in London, New York, Minnesota and Chicago.
I was offered a vast range of potential diagnoses."
Faced with all these confusing and conflicting opinions, I had to work out which expert to trust, whom to believe and whose advice to follow. As an economist specializing in the global economy, international trade and debt, I have spent most of my career helping others make big decisions — prime ministers, presidents and chief executives — and so I’m all too aware of the risks and dangers of poor choices in the public as well as the private sphere. But up until then I hadn’t thought much about the process of decision making. So in between M.R.I.’s, CT scans and spinal taps, I dove into the academic literature on decision making. Not just in my field but also in neuroscience, psychology, sociology, information science, political science and history."
What did I learn?"
If we are to control our own destinies, we have to switch our brains back on and come to our medical consultations with plenty of research done, able to use the relevant jargon. If we can’t do this ourselves we need to identify someone in our social or family network who can do so on our behalf."
It is also crucial to ask probing questions not only of the experts but of ourselves. This is because we bring into our decision-making process flaws and errors of our own. All of us show bias when it comes to what information we take in. We typically focus on anything that agrees with the outcome we want."
We need to be aware of our natural born optimism, for that harms good decision making, too."
We need to acknowledge our tendency to incorrectly process challenging news and actively push ourselves to hear the bad as well as the good. It felt great when I stumbled across information that implied I didn’t need any serious treatment at all. When we find data that supports our hopes we appear to get a dopamine rush similar to the one we get if we eat chocolate, have sex or fall in love. But it’s often information that challenges our existing opinions or wishful desires that yields the greatest insights. I was lucky that my boyfriend alerted me to my most dopamine-drugged moments. The dangerous allure of the information we want to hear is something we need to be more vigilant about, in the medical consulting room and beyond."
My own health story had a happy ending. I was finally given a diagnosis of a rare lymphatic vessel condition, and decided that surgery made sense."
My surgery went well. The pain subsided, the pounds gradually came back on. I am now cured.
With brain switched on and eyes wide open, we can’t always guarantee a positive outcome when it comes to a medical decision, but we can at least stack the odds in our favor."
NY TIMES
20 comments:
tldr
Decision made.
"When making important decisions, inform yourself as much as possible, and guard against wishful thinking."
There you go, Eric.
The rest of it is just self-congratulation, and what my sister calls "organ recitals" -- stories about someone's medical problems which he assumes will fascinate you.
Storyboard:
* Female figure suddenly dramatically thins.
* Thin figure turns white in center, bends over. Other people appear and disappear while this is happening.
*New Barbie doll girl figure goes to LONDON!
*New Barbie doll girl figure goes to NEW YORK!
*New Barbie doll girl figure goes to MINNESOTA !
*New Barbie doll girl figure goes to CHICAGO !
*New Barbie doll girl figure becomes ECONOMIST!
*New Barbie doll girl figure deals INTERNATIONAL TRADE AND DEBT!
*New Barbie doll girl figure interacts with PRIME MINISTERS!
*New Barbie doll girl figure interacts with PRESIDENTS and CHIEF EXECUTIVES!
*New Barbie doll girl figure is NATURALLY OPTIMISTIC!
*New Barbie doll girl figure SWITCHES BRAIN BACK ON!
*New Barbie doll girl figure MAKES HEALTH DECISION!
Rated:G
This is a story for girls. It teaches them that they can behave as boys. The key part is "turn brain back on" this is an inexplicable phrasing to beings who cannot turn their brains off, no matter how poorly they operate, they are always on and doing the thing called decisions, every moment, even idle moments, . Not the heart.
So. When grown, boys who vote do not say things like, "I feel in my heart this is the right way to go," while making wrenching hand motions as if their heart is being wrung like a dishrag inside there.
I take that back. Boys do grow up and say that, one did. Right before departing and leaving his miniature schnauzer with me or the day, I remember now, but he's gay, and he's liberal, and not just regular liberal-minded, he's fierce liberal, and not just regular-fiercely liberal, he's top of the pack fiercely liberal. He feels his way through life and particularly the voting booth like Helen Keller. It's pathetic. The groping and frenetic feeling around and sampling and searching for the tendermost things and getting everything wrong, except in those moments when he does manage a unity within his scrambled schizophrenia and insane story-mending his brain turns back on, as it were, and he produces a sound decision. He does make sound decisions most often, for a schizophrenic .
That kind of story.
"...we have to switch our brains back on and come to our medical consultations with plenty of research done, able to use the relevant jargon. If we can’t do this ourselves we need to identify someone in our social or family network who can do so on our behalf."
Exactly right. Unless you have a simple cold or the flu, you should go to MD appointments with enough knowledge to discuss your symptoms or diagnosis or treatments. Ask informed questions.
An MD cannot know everything about every disease. Not possible. Good MDs welcome informed patients who can discuss the patient's disease. And it's good to have a family member along to take notes.
Be proactive. Never be afraid to question the medical practitioners. Be the patient's advocate.
My wife had serious surgery a few years ago. She needed morphine to control the post-surgical pain. After she was on morphine for few days, I couldn't get her awake enough to have a simple conversation. I had her anesthesiologist paged and asked her to look at the RX on the drip.
She did, said "uh oh!" and turned off the drip. Whoever filled the RX misplaced a decimal. My wife was getting 10X more morphine than was prescribed. She would have been a goner in another 12 hours.
Being informed is good.
Except when you "inform" yourself into a belief in alternative medicine and let yourself die of a curable problem, a la Steve Jobs.
Most important is to treat the staff (doctors) like shit.
They are rich, greedy folks performing unneeded surgery to line their pockets.
Barack Obama will take care of those damn doctors if just given the power to do so.
It is useful to have someone else with you when you go, especially if you have no real medical training.
Working with people in a counseling/therapy setting it is often what people do not say that is important.
In a medical setting I find my family members often leave out information which is important because they do not know how to evaluate what is important. Sometimes it is because they forget, sometimes because they don't know. And unfortunately I have run into some docs who do not know how to really do an diagnostic interview. (They don't hear that something isn't being said, or they accept platitudes -- "fine" being the one that drives me crazy with people who believe they must never be a problem for anyone.)
One piece of advice: Before you go see the doc for whatever - WRITE down the things you are wondering about, or different feelings, pain etc. It is the deviations from your norm that are important, but you have to have an idea of what your norm is, and you have to communicate the information.
But correct diagnoses is not a simple A,B,C, flowchart.
Neither are docs, nurses, therapists, whoever, mind readers.
@ Synova 1:50.
Amen, sister.
I've been seeing stuff lately about having a doula to help with pregnancy. When I was having a kid it was all about getting a midwife or not so it seems like a doula is something different. It's in the same "natural" birth category, though. A doula seems more like an attendant who goes with you to your appointments and who helps you deal with the hospital and who knows everything that you have no way of knowing.
But I thought that it would actually be really nice to have someone who was a "helper" when you go to the doctor for something more than a regular check up. "Helpers" would be nice when dealing with your kid's school, too, or in other situations where you're essentially dealing with a different culture as an outsider. There you go... cultural translators. We could use lots of cultural translators in daily life.
Someone within an industry, be it in medicine or the kid's school administration or some other government agency or any other specialized business, doesn't always remember that what is crystal clear to them, because it's their job, is clear as mud to most everyone else.
Women have one or two kids now, so they're not going to have time to become an expert at baby-having. Hopefully people don't have time to become an expert at being deathly ill or having a mysterious illnesses either.
This person doesn't need to be a doctor or even a nurse, if they understand the *system*.
You go to school and if you don't know how to ask, you never find out what services they're required to provide or how to get them or even who to talk to. (This is just the non-medical example I'm most familiar with.)
When I decided to go back to school I couldn't figure out who to ask about how to choose a major to match my education to my goals. There was no obvious place or person to get this information from until *after* enrollment.
It's one thing to say that it's up to you to become informed and to inform yourself, but if we could really all be experts in everyone else's careers, well... I don't think that's particularly practical. It's also not at all practical when you figure that the first thing that goes when you're trying to deal with a crisis or if you're ill, is the ability to acquire new proficiencies.
Like a wedding planner...
Who really isn't capable of planning their own wedding? But here is this person who has done it dozens and dozens of times and knows everything and so you don't have to bust your brain figuring out how to rent a reception hall or find out how far ahead of time you need to order a cake.
(Easier yet is if you belong to a tight community and a small church and everyone knows exactly how to have a wedding because you just have it in the church like everyone does and the Ladies Aid makes buns and serves buttermints and You. Are. Done.)
I always thought doulas were silly inventions until I realized after my third how helpful it would be to have another woman in the hospital room with me to be assertive with the nurses. My husband tried, but the nurses just kind of glared at him with a "You evil man" kind of look. He was too scared to say anything else after that.
Exactly, Birches. Those times when a person most needs to be on the ball are just when you're incapacitated. It's impossible to defend yourself (or your baby) when you're passed out or even just haven't slept for two days straight. A husband, family member, or friend is way *way* better than not having them there, but they don't know what's going on *either*.
I would have been a goner if my wife had not been there to bitch slap the doctors and get the right information so we could make an informed choice.
You need someone to help you when you are sick because you are not just thinking right.
There's a reason that conditions at Walter Reed got bad.
1) The people there for treatment were not capable of doing anything but trying to get better.
2) The people there for treatment were separated from their units and their families and anyone who would normally have looked at mold on a wall and said WTF?
3) The people there for treatment, when they got well enough to do any of that advocacy themselves, were sent elsewhere.
4) Walter Reed is a hospital run by the Federal Gov't, which is a political mess that cares little for wounded military.
Troop's right, you need some outside assistance and the best choice is your better half. I would go with trusted family or friends after that (you know which ones to consult).
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