I have a unique hospitalist job. The "gray team" takes all unassigned stroke and TIA patients. As a result, we also get all of these patients with a strange constellation of neurologic-like symptomatology. Most of which is not explainable. Some have been complex migraines, where the migraine headache actually causes neurologic symptoms. Some of been conversion disorder, wherein the patient undergoes a strong stressor or catastrophic event and the brain, psychologically tries to protect itself, by creating a neurologic deficit… paralysis, blindness, etc. Usually, the patients are not supposed to be alarmed by their symptoms. There is no measurable problem that doctors can detect. They have normal imaging, normal nerve conduction studies, lab tests, etc. What happens is on the subconscious level. They are not intentionally faking it, they believe this is happened to them.
There are other patients who don't seem to follow the definition of conversion disorder. There are no great stressors or triggering events, they do not seem apathetic about their situation. In fact they seem terrified. I had one patient recently, a very nice genuine simple country boy type of a fellow who was a pastor. He said, "I just want to get better" as a tear rolls down his cheek. I believe him. But his symptoms don't add up! His exam fluctuates and does not look "organic" but looks like inconsistent in effort. But I do not think he does this on purpose. I think its on the subconscious level again. He is also newly experiencing debilitating headaches. All of the dangerous causes for these headaches have been ruled out… what causes these?! How do I help him?! When the symptoms he experiences are likely psychogenic, but he won't admit to any stressors but this illness… how can I help? where did this illness come from?
Interestingly, this man claims to have had no headaches or neurologic symptoms until he was giving his testimony in front of a congregation when a severe headache struck him down in the middle of his testimony. Is there still a spiritual warfare wherein the body is attacked physically? If so, how can God make me into a physician who can address these and be his instrument of aid to these people?
What role does God want to use my wife's illness to shape me as a physician?
I believe there is more to health than just the physical body. There is a body-mind connection. I am starting to appreciate and believe a spirit-mind connection, therefore spirit-body connection as well.
I'm trying different approaches to these patients. The "strong-arm" doesn't seem to do them any good… it just gets them out of the hospital a day earlier, that's all. I've used a different approach with my country pastor, and though his symptoms haven't disappeared, they are improving. And he does believe that they will eventually go away and that they aren't dangerous. I helped him understand that western medicine has figured out all of the "dangerous" disease states, thought there are mysteries left, they are usually self limiting or not particularly harming. And I think that's true.
david
There are other patients who don't seem to follow the definition of conversion disorder. There are no great stressors or triggering events, they do not seem apathetic about their situation. In fact they seem terrified. I had one patient recently, a very nice genuine simple country boy type of a fellow who was a pastor. He said, "I just want to get better" as a tear rolls down his cheek. I believe him. But his symptoms don't add up! His exam fluctuates and does not look "organic" but looks like inconsistent in effort. But I do not think he does this on purpose. I think its on the subconscious level again. He is also newly experiencing debilitating headaches. All of the dangerous causes for these headaches have been ruled out… what causes these?! How do I help him?! When the symptoms he experiences are likely psychogenic, but he won't admit to any stressors but this illness… how can I help? where did this illness come from?
Interestingly, this man claims to have had no headaches or neurologic symptoms until he was giving his testimony in front of a congregation when a severe headache struck him down in the middle of his testimony. Is there still a spiritual warfare wherein the body is attacked physically? If so, how can God make me into a physician who can address these and be his instrument of aid to these people?
What role does God want to use my wife's illness to shape me as a physician?
I believe there is more to health than just the physical body. There is a body-mind connection. I am starting to appreciate and believe a spirit-mind connection, therefore spirit-body connection as well.
I'm trying different approaches to these patients. The "strong-arm" doesn't seem to do them any good… it just gets them out of the hospital a day earlier, that's all. I've used a different approach with my country pastor, and though his symptoms haven't disappeared, they are improving. And he does believe that they will eventually go away and that they aren't dangerous. I helped him understand that western medicine has figured out all of the "dangerous" disease states, thought there are mysteries left, they are usually self limiting or not particularly harming. And I think that's true.
david
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