Physician Heal Thyself
It’s Super CJ, your online doctor.
Welcome again to my favorite column, it’s always good to have you here. Today, I want you to learn from my personal experience.
Peptic Ulcer And I
“Cura te ipsum; heal thy self,” is a sarcastic injunction used to remind doctors to pay attention to their own problems too, while trying to “save the world.” Unfortunately, most times, we don’t.
Just the other day, a barely 32 year old colleague decided to check his blood sugar, and discovered, to his utter amazement, that, not just was he diabetic, his blood sugar was hitting the ceiling at 18mmol/L [324mg/dl]! That is, almost three times the upper limit of normal. Shocker!
Well, that’s not what I want to write about today. What I want to write about is how we can be BLIND to glaring signs in our own bodies– signs we easily recognize in other people’s bodies every waking moment of the day, even when woken up from a slumber! And mind you, this isn’t the same thing as ignoring,or neglecting such signs; I’m talking about being “BLIND” to them.
There seem to be this thing that shuts the average doctor’s diagnostic acumen when it comes to his own body. Reason it is not advisable to self-diagnose, and self-medicate.
Peptic Ulcer Dismissed As “Hunger Pangs.”
One of the first diseases you learn about during your clinical years in medical school is peptic ulcer disease [PUD]. In the very first week of your clinical posting, it is everywhere for you to see: right there in the emergency department [as acute exacerbations, gastric perforation, upper GI bleeding, and gastric outlet obstruction], in the wards, and even in the clinics [in less dramatic forms]! It is just everywhere. And within a month, you would have learnt so much about it that you could easily pass for a professor of PUD, and can even spot a patient suffering from it from miles away [okay, that’s a little bit of an exaggeration]
It wasn’t any different for me. Within one week of our first set of clinical postings [M1 and S1], I had already learnt all there is to learn about PUD. The symptoms. Physical signs. Risk factors. Causes. Complications. Treatment. Just about everything. You just name it!
In my 500 level, I developed this weird feeling of “indescribable” [that was what it seemed like to me then; lol] abdominal discomfort whenever I got hungry. Because of its association with hunger, I dismissed it as “hunger pangs.” However, unlike the usual hunger pangs, this one, if not attended to urgently with GI ministration [food], would leave me “sick,” with transient loss of appetite, and a nagging headache.
I kept on wondering what could be the cause of this kind of “worrisome hunger pangs” that disappears with feeding, that I was experiencing, till I graduated from medical school, and started housemanship. Even as houseman, a practicing doctor, the diagnosis still eluded me. Diagnosis? Scoff! Fact was that, I never even thought of it as an illness, so I wasn’t even considering any diagnosis! Get the point?
After a year of housemanship, my “worrisome hunger pangs” accompanied me, like a faithful wife, to the private hospital where I was practicing while waiting for NYSC to call me up for the compulsory one year of national service. And it kept getting worse with long times spent in the consulting room, or in the ER, handling emergencies, without the luxury of food.
The irony was that I was diagnosing people of PUD and its various complications EVERY BLESSED DAY. So, it wasn’t as if I didn’t know the symptoms, and the diagnostic criteria. Just that perhaps, the symptoms weren’t as I had imagined them. You know, the classical burning epigastric sensations, accompanied by dyspepsic symptoms, and all.
One glorious afternoon, while I was clerking an ulcer patient, with my own “worrisome hunger pangs” gnawing away at my stomach, my eyes opened as I penned the diagnosis “acute exacerbation of PUD,” and realized, with dismay, that the patient’s group of symptoms were like a mirror image of mine! And that was how I realized, after 4 years, that what I had was actually peptic ulcer disease.
“Unknown Symptoms” Of Peptic Ulcer
Having peptic ulcer disease, myself, has so intimated me with th disease that I have learnt, from my own body, many weird symptoms of peptic ulcer that are not even written in textbooks, and MAY not be known to most doctors.
I can’t begin to count the number of times that weird, seemingly non-ulcer, symptoms has led me to the eventual diagnosis of peptic ulcer, on exploration of that possibility.
I am not sure how many of us who know that peptic ulcer comes with: headaches, dizziness [and I don’t mean the dizziness of hypovolemia from persistent vomiting, or GI bleeds], occasional burning sensations from the “waist line” down to the knees, tremulousness, what some people may refer to as “internal heat,” and sometimes a “hooking sensation” at the sides that usually relieves spontaneously.
I am not sure most of us know about these “unknown symptoms,” because I haven’t seen them in any text [I may be wrong about this though]; I learnt them from my own body, and I have seen them manifest in my patients “one, too many times” [in T-bag’s parlance]! It’s just like “bitterness of the mouth” is yet to make it to medical texts as a symptom of Malaria, even though it is a symptom well known to almost every black African, who has suffered from Malaria before.
A Concluding Question
Dear colleague, when was the last time you had another doctor review you? Scratch that. When was the last time you checked your blood sugar? And your blood pressure? Have you immunized yourself against HBV? Have you gotten a pap smear done? Do you do BSE at least once every month?
Dear physician, please HEAL THYSELF!