Friday, April 5, 2013

Stress Around the World

According to experts, half of our patients suffer a problem that also includes stress which a doctor must take into account. You may think this is medical science, but it’s really medical culture. “Stress” is America’s explanation for symptoms without a satisfying explanation. I rarely make the diagnosis, but patients make it for me. If a guest comes down with his third cold this month or a particularly stubborn backache or upset stomach, he’ll inform me that he’s been under stress lately.

Unlike most doctors I see patients from around the world, and it turns out that other nations don’t suffer much stress.

Germans suffer low blood pressure. It’s considered a genuine physiological disturbance. German doctors seek it out and treat it, often with medication. Long ago, I was puzzled when young Germans with fatigue, headaches, indigestion, or flu symptoms wanted their blood pressure checked. Then I learned.

The French ignore stress and don’t suffer low blood pressure. Perhaps because of the universal consumption of wine, French tradition teaches that subtle liver disorders produce many distressing symptoms. 

Constipation was once the great English preoccupation. This was thought to produce “auto-intoxication” from retained waste that leaked toxins into the body. Surgeons would occasionally remove a patient’s entire colon. They don’t do that today, but many laymen still consider it beneficial to undergo a “colonic,” in which a technician inserts a tube into the anus and washes out all those toxins.

Traditional healing in China emphasizes a medicine for every condition. I’m sure you would be insulted (and so would any educated Asian) if I were to suggest that you expect a prescription every time you see us, but doctors often get that impression.

I regularly explain to puzzled Chinese parents why it isn’t necessary to treat every symptom of their sick child. On other occasions, when I explain that an adult’s minor illness will go away without treatment, I see him exchange a look with his wife that clearly means, “What bad luck! We go on a vacation. I get sick. Then I see this foreign doctor who does not know the proper medicine!”  

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