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Hi everybody,

If you’ve been lucky enough to contract a rare disease in your lifetime, then you’ve no doubt met a bunch of medical students and had them poke, prod and probe you. It’s a law of nature that doctors love to cart their minions through the hospital to proudly display their interesting patients, much like a peacock’s tail, a lion’s mane or a drunkard’s nudity at an O’ Week party.

During this pride parade, however, there’s something that you often won’t see as a medical student. One of the biggest secrets that isn’t shared outside the medical world (besides the pill that actually does make your penis larger) is that there’s a type of patient that embarrasses doctors. Hidden within the wards are patients that fill us with more shame than the hung-over Scarfie who got their privates out for everyone the night before. They are the patients with medically unexplained symptoms.

Defining what a medically unexplained symptom is doesn’t require a six year degree or $100,000 student loan. Heck, I’m willing to bet that most of you would be able to come up with a definition if pressed for one. But for the benefit of the PE students being read this by a literate friend: a medically unexplained symptom is a symptom that isn’t medically explained.

Defining the condition isn’t the problem, though; diagnosing it is. Diagnosing a medically unexplained symptom brings us docs more shame than when we arm-wrestle a PE student. Or a gender studies student. Or one of those ridiculously smart 12-year-olds who go to University in between art class and story time. Despite there being no underlying organic cause, most doctors still see diagnosing a medically unexplained symptom as admitting defeat in the search for an answer. Doing so is effectively asking an academically-driven, former health-sci to publically document the fact they didn’t know the answer to a question in the terms test of life.

In these situations, we utilise the tactics of the schoolyard bully: we divert attention away from our ignorance and shame by making others feel ignorant and shamed. We medicalise things and overcomplicate them to justify our degrees, using big words and a side helping of Latin to make it hard for laypeople to understand exactly what we’re talking about. Medically unexplained muscle pain becomes “fibromyalgia,” medically unexplained stomach pain becomes “functional dyspepsia,” medically unexplained gut problems become “irritable bowel syndrome.”

There are more reasons why we medicalise things and overcomplicate simple terms, some of which may be more valid. I’m not an epidemiologist (health researcher), psychologist (mind understander) or a cunning linguist (intelligent language expert), so I won’t delve too deeply into why we tend to medicalise medically unexplained symptoms. Suffice to say, there are some rational reasons behind doing so, such as shared risk factors between their conditions; suggestions of a symptom-specific organic cause in some people with the symptoms; and significant overlap between conditions of the symptoms. A large part of it still tends to be to give an “answer,” however.

If you ask your doctor to diagnose your ongoing muscle pain, you’ll both be more satisfied with a diagnosis of “fibromyalgia” than one of “ongoing muscle pain.” Before you get either diagnosis, however, you’ll probably be unnecessarily investigated just in case the doctor can somehow solve the puzzle, find a rare diagnosis to be proud of, and avoid the shame of a medically unexplained symptom.