Gosh darn it…I had a pretty good streak going…more than 54 years without an inpatient stay at a hospital. Until the latter part of this past July, that is.
My experience of that stay, along with a focused effort to get to the bottom of a health mystery, has prompted me to say something about the state of health care and medical education in this country. The mystery? A long standing conviction that an underlying systemic dysfunction has been responsible for an abiding fatigue and general worsening of my health over that past 5-6 years.
In the event of a trauma to the body or an acute medical emergency, the U.S. medical establishment provides high-quality intervention to address the problem and promote subsequent healing. The surge of adrenaline combined with a thorough command of what a doctor learns in the various stages of his/her education, provides a great shot at full recovery from even the most life-threatening adverse health events. If I break a bone, am shot, have a heart attack or stroke, or am in a motor vehicle accident, take me to the emergency room.
On the other hand, many hospitals and doctors seem less well-equipped to help patients who suffer from chronic conditions for which it is difficult to obtain clear evidence from diagnostic tests. Patient presents with complaint, doctor orders blood or other tests to confirm or rule out the most likely disease, test comes back negative, patient still complains, more tests ordered with same or different results, and the cycle continues, and often the outcome is that the doctor can find no hard evidence to support the patient’s complaint. Conclusion: there’s nothing wrong with the patient. Patient still feels unwell, becomes more frustrated, well, you see how this goes… In the worst case, the doctor may tell the patient there is nothing wrong with them and that what they are experiencing is “in their head.”
I think the problem is that the medical establishment has tended to reinforce a growing specialization in smaller and smaller areas of expertise, so that every possible complaint corresponds to a matching medical specialty, and the chronically unwell patient begins the endless cycle of running from specialist to specialist as new complaints arise, never mind that these seemingly unrelated complaints are actually the consequences of a failure to find and treat the underlying disease process. Medical education seems to have evolved to an increasingly brutal quest to commit to memory as much stuff as possible, leaving little to no time for students to think about how the various major systems in the body interact, as well as how and why they respond to toxins, nutrients, and other stimuli. Never mind the growing realization that these effects may present in very different ways in different individuals. This is precisely my story…
In my case, I was finally diagnosed with Hashimoto’s thyroiditis earlier this summer and was promptly sent off to CVS with a prescription for synthetic thyroid hormone, never mind that my TSH and free T4 levels are normal. Apparently this is standard treatment for this finding. But here’s the thing. There are a number of possible disease pathways that result in a positive test for thyroid antibodies, only one of which responds to synthroid.
To make a long story short, my discovery that eliminating gluten from my diet is key to stopping the auto-immune attack on my thryoid and restoring my health came through my own diligent search for an explanation for my declining health. Never once did either my primary care doctor or any of the specialists to whom I was sent ever suggested that a food sensitivity could be responsible for the alarming and mysterious decline in my health. I was not satisfied with the treatment of every new ailment as if it were isolated from every other condition. I am not interested in amassing a veritable stable of experts, each of whom treats a part of my body as a mechanic would treat a faulty water pump in a car.
The story is not yet finished. It will take some time to regain the health I had before all of this started, but I am heartily encouraged by the difference I feel having committed to the elimination of gluten from my diet. My energy levels have improved, and my metabolism seems to have restarted – Rabbie (my 11-month old Cairn Terrier) gets much of the credit for a reduction in my stress levels and an increase in my physical activity, resulting in a reversal of the slow but steady weight gain that has accompanied my declining health. However, without a more active metabolism, I would not have been able to continue the weight loss and reduce the dose of medication I’ve needed just to keep my eyes open during the work day.
No matter how the story unfolds, my main take away comes as an image of an orchestra. My wellness on all levels – physical, mental, spiritual, emotional – depends on a number of key team members. But no matter how good the individual practitioners, they need me to be an active and engaged conductor to focus their efforts in achieving the best possible performance.
I wonder if my story and the stories of others might reach the hearts and minds of those who are preparing our future MDs and DOs for practice. It seems from what I am finding in my own self-directed study of the functional medicine paradigm, chiropractors, nurses, nutritionists, and alternative healthcare providers have been getting the message in far greater proportions than have the docs who wield most of the power to influence healthcare policies and practices, and whose participation will help to lower out-of-pocket costs for patients desperate for relief. I’m very grateful that I’ve been able to find a primary care physician who does have some background in functional medicine. God is good, and if a stay in the hospital is what I needed to give me time to engage in a little medical research, I guess I can say I’m grateful for the end of my streak of luck in avoiding inpatient hospital stays.