What many laymen believe are serious signs are
not. Here are examples.
1. Local pain is worrisome; widespread pain is
reassuring.
When a guest suffers abdominal pain, I ask to see
where it hurts. When he or she indicates the entire abdomen, I relax a little.
The common stomach virus produces widespread pain. When the patient’s finger
rests on a small area, I worry about conditions like gallstones, appendicitis,
or diverticulitis whose pain is usually localized.
2. One allergy can be serious; many allergies:
not so much.
An allergy is a specific immunological reaction
that can be fatal, but most drug reactions are not allergies. If a medicine
upsets your stomach or gives you a headache that’s usually what we call “drug
intolerance.” If you’re willing, it’s OK to continue it, something we never do
with an allergy. However, doctors use “allergy” indiscriminately, and laymen
add their own diagnoses, so many patients confront us with a long list of
forbidden drugs, foods, and environment stuff. The major consequence is not
illness but expense. If you say you’re allergic to penicillin (90 percent of those who say so are wrong), for example, an
alternative costs fifty times more.
3. Things don’t turn into other things.
Mostly this comes up with viral upper respiratory
infection (cough, congestion, sore throat, fever). Everyone knows that antibiotics are useless
for viruses, but if a doctor diagnoses a virus, many patients believe they’ve
wasted the trip. This is where the maxim comes into play.
“If I don’t get something it turns into…
“bronchitis…strep…pneumonia…a bacterial infection….” It doesn’t. In otherwise healthy people,
illnesses don’t change into other illnesses, and experts persistently warn
doctors that giving antibiotics to prevent complications is positively harmful.
They wouldn’t keep warning us if we didn’t keep doing it.
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