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Medically Unexplained Physical symptoms (MUPS)
Patients
commonly present to doctors with symptoms or complaints. Complaints are
usually of pain and alterations in structure or function of body organs
or regions. Doctors are like Sherlock Holmes. Their aim is find out
what is wrong with the patient. This exercise is based on the data he
is able to collect by history (accurate description of the difficulty
including its location, factors associated with onset and termination,
duration, nature or quality, other accompanying symptoms etc) and
physical examination (aimed to uncover objective evidence to support
the symptom – findings like swelling, warmth, restriction of movements
or altered sounds during heart beats, breathing etc).
Usually the doctor rules out serious conditions by the above methods, makes an informed guess (provisional diagnosis) about the likely cause of the symptom and prescribes treatment like drugs, dietary changes or other advice. He may order additional tests to confirm or rule out other causative conditions. All this looks fairly simple and straight forward.
Sometimes the doctor senses that the patients’ complaints and objective evidence (obtained by physical examination or tests) do not match. Some patients do not show concern even when they are told that they have serious diseases. Others are not relieved by such pronunciations by the doctor and appear unconvinced, tense and worried.
Both these situations need special attention. Many of the patients who fail to get relief from modern medicine later seek help in alternative systems of medicine as there is no conflict between them and experts in these fields. Practitioners of alternate systems have a very ill defined concept about basic anatomy, physiology and pathology. They are not worried about the mismatch between subjective report and objective evidence like experts in modern medicine. They are in a primitive state (or post modern state with contextual interpretation of reality) and happily listen to long narration of bizarre symptoms uncritically.
The emotional relief obtained from this ventilation may be partly responsible for the therapeutic gains obtained. Some who fail to get relief even from them, flock to faith healers or quacks and demigods out of desperation.
Doctors of modern medicine need to rethink why they are helpless or driven to desperation by such patients. We need to be tuned in to the cues of emotional distress voiced by the patients, and hone up our skills as counselors and emotional healers.
Usually the doctor rules out serious conditions by the above methods, makes an informed guess (provisional diagnosis) about the likely cause of the symptom and prescribes treatment like drugs, dietary changes or other advice. He may order additional tests to confirm or rule out other causative conditions. All this looks fairly simple and straight forward.
Sometimes the doctor senses that the patients’ complaints and objective evidence (obtained by physical examination or tests) do not match. Some patients do not show concern even when they are told that they have serious diseases. Others are not relieved by such pronunciations by the doctor and appear unconvinced, tense and worried.
Both these situations need special attention. Many of the patients who fail to get relief from modern medicine later seek help in alternative systems of medicine as there is no conflict between them and experts in these fields. Practitioners of alternate systems have a very ill defined concept about basic anatomy, physiology and pathology. They are not worried about the mismatch between subjective report and objective evidence like experts in modern medicine. They are in a primitive state (or post modern state with contextual interpretation of reality) and happily listen to long narration of bizarre symptoms uncritically.
The emotional relief obtained from this ventilation may be partly responsible for the therapeutic gains obtained. Some who fail to get relief even from them, flock to faith healers or quacks and demigods out of desperation.
Doctors of modern medicine need to rethink why they are helpless or driven to desperation by such patients. We need to be tuned in to the cues of emotional distress voiced by the patients, and hone up our skills as counselors and emotional healers.
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