Monday, December 21, 2009

Legitimacy VII: Denialism / Medical Fatalism

The author if Denialism was on the Daily Show recently, and he talked for some length about various aspects of denialism. Most of the points were well taken. One of the things he was talking about, however, was increasing paranoia about vaccination, and there I wonder if he didn't miss another point that's equally important.

I've watched quite a few people in and out of the hospital recently -- family and friends -- and I've started hearing the same phrase come up over and over again.

"Doctors don't know anything."

The story goes just about the same every time. Someone goes to the doctor with some very bad condition. The doctor either comes up with a label for it, or isn't able to make a diagnosis. In one case, the doctor told them that it was psychological. They test them out on some prescription drugs that don't have any effects. Months go by, with a few more trips to the doctor, to other doctors who give wildly different prescriptions. Basic mistakes are made; in one case, it takes four doctors before any one of them considers running a test for mono, despite the fact that all of the symptoms are consistent with mono. In another case, a doctor wants to give the upper layer of skin an acid wash, which another doctor calls completely hyperbolic and unnecessary.

The story usually ends the same: the person in question stops wanting to go to the doctor. They say that sentence above ("Doctor's don't know anything!") and wonder why they should waste money and time for doctors who don't appear to know more than them.

I have to admit that I have had one of the most galling examples of this in my life while I was in a fairly good hospital in the Czech Republic (a private clinic, which was targetted at wealthier ex-pat Americans or visitors). I came in with a condition that I had had diagnosed in the US before I left, but which hadn't improved. I told the doctor all the information I knew about the subject. He Googled it.

Let me repeat that. A Doctor GOOGLED MY CONDITION IN FRONT OF ME. AS I WAS SITTING IN HIS OFFICE.

I could have done that. In fact, if it wasn't for the fact that the medication I needed to relieve my symptoms was by prescription only, I never would have bothered going to the doctor -- after all, the last doctor had given me enough information for me to treat myself.

It feels like, over time, I've observed a fatalism about medicine taking hold in myself and my friends.

So when the author of denialism was talking about people avoiding getting vaccinations, I have to admit, I have also been avoiding some of those vaccinations myself. That's not so much because of denialism, but because, well, the last two times I got a flu shot (three and four years ago, respectively), I instantly caught a fever with muscle pains and respiratory illnesses. When I went to the doctor, insisting that I had gotten the flu after taking the flu-shot, he told me that what I really had was a "flu-like severe cold." Ah. Well I feel much better then.

(Update: realized I was actually on part 7 of Legitmacy)