Saturday, November 3, 2012

Differentials






This reminds me of the dialogue “Differentials” the House MD type, the one with which he usually  sits along with his team, a white board and a marker to make the scene perfect. I curiously watch this in every episode. Well not every case that they encounter is as simple as the above. Every gobbledygook sitting eighteen hours a day in front of a screen or working with files or scribbling away his signature on papers or doing just nothing will end up with these symptoms, thank the acid in his stomach, not anything else. Just in case if he realizes that he is a ‘male’ and if he is sure about that, he will have something to feel better. Three out of five differentials are ruled out here, bless him.

Diagnosis is a clinical skill, doctors work day and night to perfect it even after years of medical schooling and practice. It is appalling to see how easy this duty of theirs is projected out to be. Only a medical professional understands the danger of it, and faces it ultimately. The pros of this knowledge at your finger tip is this, firstly you know what is wrong with you, secondly you know what is the treatment for it, thirdly and more importantly you know whether your doctor is right. Well so you think, but there is more to life, more to death and  even more to everything on the thin line in between. 

When there are people who are trained well to handle it all  we all fear their credibility. I as a doctor myself do, we inquire about their experience, we take a second opinion, maybe a third, a fourth. The concern is but natural, our right if you were to ask me. But how far does this ‘browsing’ help we really do not know. Like every abnormal thing has a term in the medical dictionary we haven’t left this condition either. Check this out: Cyberchondria. Doctors themselves aren’t behind, heard of  The Third Year Syndrome ? All the knowledge about the normal working of a human body- anatomy, biochemistry  and physiology coupled with the abnormalities learnt in  pathology, microbiology plus the drugs to fight them in pharmacology is enough to drive them nuts before getting into the final year. From advanced lung cancer  for a cough, a brain tumour for a headache, rabies after a squirrel bite, tetanus after a staple prick, well  they are the important differentials. Been there, done that.

Hugh himself puts it right, his take on the character of Dr. Gregory House MD “Yes, I still like him very, very much. I know he has problems, and he is not necessarily a good man. But I realized long ago that one doesn’t only like good people. Sometimes one doesn’t even like good people.” We do not like doctors, we do not love them, we do not want to go to them. So where is the trust, what is it all about? Fortunately or not so, sometimes they are the only resort.

Opinion and more so fright apart, things that one should consider when someone or something gives them information about matters related to health: authenticity, reliability, applicability, some sense and sensibilities. Nothing more, nothing else. At the end of the day it is the doctor, who knows what the best is. If he does not, maybe he is learning, maybe he is not. Or maybe that is why we and our search for the ‘Differentials’.

Picture Courtesy

 "The normal treatments don't always work...symptoms never lie"

Dr House in Season 3 - The Jerk

-R

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