Why Doctors Don't Listen

[Guest guest]

HI All,

I am quite sure that you are facing the same problem that my wife,

who rarely complains about anything, became madder than the

proverbial wet hen over. In fact, the past six years of my life

have been driven by her complaint that her doctor would not listen

to her complaints. He only gave credence to the laboratory tests.

Her complaint reminded me of the complaint that musicians have about

audio design engineers. It seems that the founding engineers made a

bad assumption about the nature of human hearing -- that it does not

produce any harmonics. Then they assumed that amplifiers should

also not produce harmonics. However, musicians find that certain

additional harmonics adds to the flavor of the sound -- they

appreciate these embellishments. So the amplfiiers that musicians

like do not pass the engineering tests for no harmonics -- no

embellishments. The engineers do not listen to the musicians

because they have their academically annointed tests.

All of this was done during the heyday of a philosophy called

Behaviorism. Behaviorism distrusted the mind in general. It

insists upon " objective " tests instead of the " subjective " tests.

Although Dr. Spock's influence killed Behaviorism, this

objective/subjective vestige lives on -- often to our detriment.

Why? Because the worst " objective " test routinely trumps the most

expert " subjective " judgment.

So when you make your subjective complaints and your physician makes

his subjective clinical evaluation and then he looks at your lab

test results, what will he believe? Oh, don't you know it quite

well -- the " objective " lab results.

The common problem here in both these cases is that the tests do not

reflect reality. In particular, the thyroid tests do precisely

that -- they test the functionality of the thyroid. They do not

test for all causes of your symptoms. Other tests are needed for

that. Although there are tests for many potential causes of your

symptoms, there are no widely accepted tests for post thyroid

deficiencies or behaviors -- the mimics of hypothyroidism.

So a deep philosophical question here is this, is an " objective

test " based upon a " subjective " assumption or an errant assumption

truly objective? I don't think so. The test should represent

reality. The test results should be provided in a real context. I

am quite sure that normal TSH and T4 results show that the thyroid

gland and the prior glands are functioning properly or nearly

properly.

However, the real context is different. The thyroid gland is NOT

directly connected to symptom production. There are post thyroid

functions between the thryoid gland and the symptom producing

cells. These functions are the peripheral metabolism of T4 to T3

and the reception by the peripheral cells (your body's cells) of the

T3. Medicine does not test for these functions.

The critical issue is whether or not the T3 in you body is being

used by the cells. The T3 being available does not mean that it is

being used. (This issue is rather like screwing in a burnt out

light bulb into a working socket. The voltage being there does not

indicate fully that the bulb will produce light...)

Consequently, both you and your doctor can be correct up to the

point that he diagnoses you as fit and must be suffering from some

sort of functional somatoform disorder or provides some lame excuse

for your condition. Should such a diagnosis be made, then the

killer response is to point out that such diagnosis can only be made

in the absense of any potential physical cause since there is no

proof possible for the diagnosis of " functional somatoform

disorders. " Since the thyroid function tests are precisely that --

measurements of the behavior of the thyroid gland -- not all

potential physical causes have been eliminated -- a requirement of

the differential diagnosis protocol that should be engraved in all

physicians' training.

This will put your physician in a rather uncomfortable box. On the

one hand he can be quite unethical and refuse to deal with the

problem -- which will signal a change of physicians -- no doubt a

time consuming and perilous necessity. Or he can become liable to

sanctions by the British Thyroid Association via the General Medical

Council -- not welcome either.

That puts us all in trouble in one way or another. But since the

power is the hands of the physicians, it really injurs us....

It is truly time to recognize the spreading cancer in this

situation. It is not the practicing physicians, but those master

physicians who control them.

The bottom line is simple, if you want your doctor to listen to your

complaints of the symptoms of hypothyroidism, we have to impress the

medical powers that post thyroid operations do exist. Of course

they do exist -- there are hundreds if not thousands of medical

science paper published on them. They have been known for 40

years. They were discovered by Refetoff, Braverman, and many

others. Their effects were first noticed more than a half century

ago by Refetoff when he found some patients being treated with

levothyroxine sodium had continuing symptoms. Sound familiar? That

was in the 1950's !!!!

We should ask ourselves, just what is motivating the " gods " of

endocrinology to be so oblivious to our suffering? What human

frailty is leading them to their abusive positions?

Be assured that Sheila and I are working on this. Although we have

truth and physiological realities on our side, the opposition has

established credibility and power on their side.

I have been at this for about six years now and it seems like we

have hardly moved forward a hair's breadth. Nonetheless, I am

convinced that we need to keep trying.....

Have a great day or at least a better day,