Friday, March 16, 2007

Medical Mumbo Jumbo

One of the first things we usually ask a doctor after he or she exams us or performs a battery of tests is some variant of, "What do I have?," where we mean to be asking what disease we are suffering from. We are not asking for what symptom we have. We already know that at least to some degree. But what we get will often be a Greek or Latin name for the symptom we have just told the doctor we are suffering.

My podiatrist told me the other day that he had once been diagnosed with "metatarsalgia." This is a morphologically complex term crafted out of foreign language morphemes that mean "pain in the ball of your foot." So, the answer to his question of what he had when he said he had a pain in the ball of his foot was that he had a pain in the ball of his foot. An even more obvious example of the use of a name of a symptom counting as the answer to the question, "What do I have?," also from podiatry, is "Haglund's deformity," which is said to consist of "a bony enlargement on the back of the heel that most often leads to painful bursitis." In neither case, matatarsalgia or Haglund's deformity, do we get any more than the name of a symptom (consequence) of something. What we really want to know is what this "something" is. Even the term "bursitis" in the definition of Haglund's deformity doesn't really help. This term itself just names a symptom, not a disease. It means that one of the many bursa sacs have become inflamed.

Early in my grade school years, I developed the functional equivalent of hay fever though it was clear that I didn't have hay fever. My eyes watered and my nose became very leaky as in hay fever but attacks of this didn't coincide with hay fever season. Since it wasn't hay fever, the natural next best guess would be that I had some sort of allergy. So, I underwent a wide battery of allergy tests but came up allergy free. Only when I was in my 60's did I luck out and have an attack of this disease that coincided with a doctor's visit. My doctor checked out the nasal fluids and exclaimed that I had "nonallergic rhinitis." I was overjoyed until it registered with me that she had not told me what I had but what I didn't have. She was saying that I had rhinitis (but I already knew that since all that means is that I had a leaky nose) and that it wasn't due to an allergy. However, it turns out that there is a prophylactic treatment for my unknown malady and that made me a lot happier than finding out what disease I have.

In fact, there are many disease names like that that tell us not what we have but what we don't have. I asked my podiatrist if he knew of any medical diagnoses that began with "nonspecific," for I was pretty sure there were some. He said he had once been diagnosed with "nonspecific hypertension." What a relief that must have been! He was being told he had high blood pressure but no one knew what kind of high blood pressure he had.

Even "hypertension," is not itself a disease name but rather, is a name for a symptom of some unnamed disease for it tells you that you have high blood pressure. If you Google "types of hypertension" you will discover that there an array of types beginning with "primary" or "essential" hypertension. This is the most common kind of hypertension but at one web site, it is claimed that medical people don't know its cause.

In addition to that sort of hypertension we also have "secondary hypertension." This sort of hypertension can be "cured" by life style changes -- lose weight, exercise, avoid salt when possible, etc. Then there are malignant hypertension (you are in deep trouble), isolated systolic hypertension (the higher number gets too high but not the lower number), white coat hypertension (going to the doctor elevates your blood pressure), and "resistant" hypertension. As you will have guessed, this last type of high blood pressure is not easily treatable. I haven't found "nonspecific hypertension" on the web yet but all it could possibly mean is that you have high blood pressure and it is not one of the kinds I have already listed.

In the case of hypertension, there must be a multiplicity of possible causes for there are a multiplicity of different kinds of drugs for treating it. I take relatively small doses of four drugs, each allegedly doing something different from what the others do. This combination has worked beautifully (knock on wood) and I resist all suggestions by doctors that I might lower the doses of one or the other of these drugs. One reason I resist is that they disagree about which one I should lower. The other is that my blood pressure falls within the normal range and I am a firm believer in not fixing what ain't broke.

I must seem to be suggesting that doctors are running some sort of linguistic con game with us but that would actually not be fair. There are really two questions we want answered. The first may be "What do I have?" but the most important is "Can it be fixed?" right now I am dealing with exactly this situation and on Monday I will see my " Pain Guy" about a crippling sharp pain in my upper leg when I walk. There are, in my case, at least two possible analyzes -- some lower back spinal issue (I have had two surgeries in that region) or some pulled or badly strained muscle or tendon. I suppose I want to know what the origin is but I am much more interested in whether it can be treated.

I don' t know why exactly medical people started creating technical terms out of Greek and Latin linguistic elements but one reason may have been that Western medicine grew out of Greek and Roman medicine and that the use of Greek and Latin terminology is partially due to that. There is also the fact that early Western science and philosophy was written in the scholarly languages of the day including especially Latin rather than the local vernaculars. This too could have resulted in the use of "scholarly" terms. What I am pretty sure of is that doctors today do not use their arcane linguistic terms just to confuse us.

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Anonymous Anonymous said...

I like this post.
I like being informed on the non-political issues a lot more.

10:51 AM

Blogger concerned citizen said...

What I am pretty sure of is that doctors today do not use their arcane linguistic terms just to confuse us. I agree. but most of us go expecting some kind of answer. esp. with the money, time & putting up with diagnostic testing involved.

This way when our friends & family want to know what's wrong with us, we have some mumbo jumbo to impress them with.

11:21 AM


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