Doctors, I realize that y’all have a hard job and I wouldn’t trade with you for the world.
That being said, I have quite a lot of experience with chronic illnesses: my mom, sister, best friend, and myself, among others, all suffer from some form of chronic illness. So I know what I’m talking about when I say that I’ve noticed a pattern during the fight for diagnosis.
Last week I walked into the doctor’s office with a resting heart rate of 112, some dizziness, nausea, unending fatigue, and chest pain. Overall, I was feeling pretty gross, but much better than I had a few days before in the ER with a resting heart rate of 132 and all the aforementioned symptoms, plus actual vomit.
When I got into the internist’s office, she looked at the blood work the ER had done; she had plenty to look at, since I’d been in the ER three times in just twelve days. I knew that the blood work showed several instances of low magnesium and potassium, but it also showed that the ER had ruled out what they called “the top ten worst things” I could have.
The ER had sent me here, telling me that there was certainly something wrong but they had covered their bases, so I should try an internist.
So there I was.
The interist listened to my symptoms. She checked my heart, told me it was irregular, and then proceeded to say, “Well, the ER has tested for everything I can think to test for. I will order more blood work to redo some of that, okay?”
And then she did it.
She asked me about college. “Is it stressful?” She said, winding herself up to say what I knew she was going to say. “Anxiety could do this, you know.”
And you know what?
No. Anxiety couldn’t do this. Anxiety doesn’t cause your heart rate to shoot up into the hundreds every time you stand; it doesn’t cause magnesium and potassium deficiences, nor does it cause low blood pressure. It doesn’t cause your heart to suddenly start racing in the middle of the night, when you’re asleep. Or when you’re sitting on the couch watching a rom-com with your family. It doesn’t do that.
That didn’t stop her from suggesting it again ten minutes later, though. “You know,” she said as she popped her head back through the door after ordering my blood work. “Anxiety could do this.”
This is the aforementioned pattern. Anxiety or stress is the excuse some doctors run to when they don’t know what you have. The doctors who do this probably don’t want to admit that they have no idea, but as a patient, I’m begging you: if you don’t know, tell me. I’ll respect you and trust you so much more if you just admit to me that you don’t know. Refer me to someone who might.
Telling me that it’s anxiety when it clearly isn’t cuts off a possible route for diagnosis.
You have made yourself a road block for every patient you do this to. When my best friend was sick, she had doctor after doctor tell her she was simply anxious from her senior year of high school.
They looked right past her weight loss, severe nausea, vomitting, and erratic heart rate and blood pressure and, with no better answer, blamed anxiety.
It took her eight months to get a real diagnosis, and it was a chronic illness, not anxiety.
If you are honest with your patients and refer us to someone else, you have branched off and given us another chance at diagnosis. Blaming anxiety because you have no better answer does nothing for us¾it hurts us, in fact.
As a patient, I honestly think it is irresponsible. As a doctor, you have taken on the responsibility of caring for my health. You may not know the answer, and that’s okay, but you don’t get to lie to me.
I will never refer my friends to a doctor who suggests to me that a legitimate illness is just anxiety.
I will refer my friends and family to a doctor who admits when they don’t know the answer. That is a doctor I can trust.
My PCP did exactly that: he knew that he had no idea what is causing my symptoms, so he looked me in the eye and said, “I honestly have no idea what’s causing this. Clearly something is going on, but I can’t tell you what.”
He then proceeded to refer me to a cardiologist; even more than that, he had his nurses arrange the appointment for me. He got me an appointment the very next day. I didn’t have to wait weeks to see a cardiologist, which I likely would have had to do if I had made the appointment myself.
Now, I’m not saying that you have to arrange the appointment for every single one of your patients. This doctor went above and beyond. I respected this doctor long before he did this, because he has always been honest and genuinely caring.
Now I absolutely love him.
I will recommend him to every single person who asks me about a good PCP. He is good at what he does, compassionate, and honest when he doesn’t have a clue. We need more doctors like him.
So, to the doctors and future doctors reading this, please be the kind of doctor that we can trust. I understand that it is probably embarrassing to admit when you don’t know the answer, but we need your honesty.
It feels indescribably hopeless to have a doctor push aside your symptoms to blame anxiety, especially when you have waited for weeks or months for the appointment, hoping that they’ll have at least a few thoughts, only to hear them skip right to “Anxiety could cause this, you know.”