And then My Doctor Laughed...

I have been thinking lately. I know the trope about people needing to tell you their IQ's and all, but, bear with me. I'm not stupid, I'm not average, I'm actually smart. Someone with a 120 IQ is smart. Mine is 142. If you put a thousand people in a room, 6 of them would be smarter than me. Now, there are all types of smart. Some people can do complex math in their head, some people can name every person they've met, others know obscenely detailed facts about things. Mine, is none of these. Mine is one of logic and seeing connections and understanding how things work together. Even then, I have gaps... I got a C in Organic Chemistry I and II - they never clicked. I knew people I could do circles around in other classes that got A's in those classes. So, there are definitely different types of smartness. I think my type is especially adept at testing which is probably why I scored so well on the IQ test.

Why do I share these details? I share because it is frustrating to not be taken seriously by doctors. They think they are so smart and informed. But, every doctor you visit is a clinician. They are not an academic - even the academic physicians I know are not academics in science. They are academics in processes or studies. For them, novel scientific thought does not exist. If it is not published, they cannot consider it. They lack the ability or desire to consider that documented science can exist outside of their availability. Today's doctors assume that the body of knowledge of what we call medicine is publicly and readily available. In days past when knowledge existed only in people's minds and in books, doctors had to use original thought and science. Today, your PCP just refers you to a specialist and all specialists assume they know the complete body of knowledge on their specialty.

Today's case in point: my follow-up with my PCP from this morning. I've said before that I've been with my PCP since this all started. Over 28 years at this point. He's right about my age, so he was fresh out of residency when I became his patient. He's not a stupid guy, but he's a clinician. Basically, clinicians operate on heuristics and decision flow charts. Artificial intelligence will do a great job replacing these docs, because they just follow decision trees and they don't listen much to anything the patient says. An AI can do that for less, basically for free, although I'm sure they will charge a mint for the AI - it should be free.

So, today I went in for my follow-up. I explained that the Lyrica he previously prescribed does an excellent job of treating many of the pains in my arms. I went on to explain that my shoulders are still horrible and that in addition to the rotator cuff pain in both shoulders my shoulders are also tight - meaning I cannot lift my elbow past just below shoulder level. I explained this is related to the shrinking of the ligament cells caused by the sodium/potassium pump being run in reverse due to the candidiasis in the cells.

Then while he was updating my record, and I knew I had him for another five minutes or so, I said, "So, I have you for another five minutes or so. Indulge me." I said, I had been seeing him since the beginning of all of this 28 years ago and that Occam's razor is a principle that says the solution that requires the least number of assumptions is most likely the correct one. This is often over-applied and it is certainly not a rule, more of a heuristic. I then said, the likelihood that I've had 28 years of weird issues and it turns out fibromyalgia is the single cause of everything is highly improbable. The assumptions you would need to make to connect it to all the problems I've had over the years are numerous. It is more likely that something else better explains everything without requiring as many assumptions.

Then I said, as Sherlock Holmes said, when you have eliminated the impossible, whatever is left, no matter how improbable, is the likely answer. Over the last 28 years, we have eliminated all the known (ie. publically documented) possibilities, and the diagnosis I've always put forth remains the only one that can explain everything.

Then I said - the basic premise is that the pituitary takes over the regulation of the electrolyte balance. This was based on an experiment from the turn of the 20th century, but what I've come to realize is that the science used to fully explain the experiment was not discovered until later. Because the condition would allow someone to go long periods without water or sustenance without having electrolyte imbalances, the condition was looked into for the super-soldier program. When? Well, all the hormones, Krebs Cycle, and other biological processes were not well-documented until the 1930s to 1950s and later. So, anyone using that knowledge to explain the condition did so by learning about it during Post-Nuremberg times. That means the experiments these second researchers did were against agreed-upon ethical guidelines. They would have been conducted during the Cold War and assuming the patients were initially treated 1950s, they would have lived until at least the mid-1970s. The only people that would be able to get away with that are top-secret military researchers. It simply would not be allowed in general academia - it would never get published as research.

Then my doctor laughed.

Realize, I'm content with my path. I accept that I will die of this in the near future, most likely without ever receiving any type of a confirmation diagnosis, but it is so condescending for my physician, who by all odds is less intelligent than I am, to discount not only my life experiences but also my logic. I fully realize that I could get 100 physicians in that room and get the same reaction, but it is still disappointing. I hate to say I will have the last laugh, but there, I said it and even made it into a pun.