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Education versus experience

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

There is often a chasm of a disconnect between what doctors know (or think they know) about chronic pain/illness and what patients know (or think they know) from their extensive experience of it, making this tweet very funny-because-it’s-true:

The British Journal of Sports Medicine replied delusionally:

“No doctor would speak to a patient in such a patronizing, haughty manner.”

O RLY? There are many counter-examples in other replies from patients, lots of poignant real-life examples of patients’ stories being ignored in favour of limited book learnin’. They should be required reading for doctors (which might well be why this was tweeted out by Trish Greehalgh, a “Professor of Primary Care”). Here are three that jumped out at me, edited for clarity, comments added in [brackets]:

  • I complained about period pain. My doctor said, “You seem to be complaining about this a lot. Are you happy being a woman?” Turns out I have Endometriosis! [Endometriosis could win an award for Nastiest Cause of Chronic Pain Most Likely to Be Ignored By Doctors.]
  • Hobbled into emergency room, saying I’d broken my ankle. Doctor told me, “If you’d broken it, you couldn’t walk.” Two weeks later finally got an x-ray. Specialist advised pinning as it took so long to heal. [Ah, the old “you’re too functional to be taken seriously” gambit… and for acute pain, no less! But every chronic pain patient knows this one well!]
  • I’ve never gotten a single proper diagnosis by listening to my doctors. I always self-diagnosed first and had to lead my doctors to the right conclusion. [Been there!] I’m a young, healthy looking black woman and I face a lot of bias in the doctors office. [Haven’t been there! Black women are particularly likely to encounter a bizarre combination face both sexism and weird racist assumptions about their “toughness” or capacity for suffering. See inequality and pain.] I’ve had every condition I’ve ever had blamed on stress/faking it/anxiety etc. Even my broken finger has been blamed on anxiety. [That sounds too ridiculous to be real, but I have seen several similar examples over the years.]

Dr. Greenhalgh clarifies in a follow-up tweet: “It’s not my idea — similar sentiment expressed less succinctly has been circulating for a while, and someone said they’d seen a mug with it on!”

Indeed, the “don’t confuse your Google search with my _____” is a well-established meme, mainly for doctors and lawyers, found on many mugs and T-shirts. But the retort — “don’t confuse your 1-hour lecture in medical school” — is a much more original rebuttal, and I do not know the source.

This is such a gem that I’ve added it to a few different articles around where I think readers will appreciate the amusing perspective, like A Rational Guide to Fibromyalgia, Science versus Experience in Musculoskeletal Medicine, and Alternative Medicine’s Choice.

PainSci Member Login » Submit your email to unlock member content. If you can’t remember/access your registration email, please contact me. ~ Paul Ingraham, PainSci Publisher