So yesterday’s high in Dallas was 97 degrees. I think the majority of Dallasites are a little bummed about that. We were two days short of hitting the record for the longest streak of 100+ degree days. (The summer of 1980 set the bar.) And then some stupid clouds rolled in and ruined our streak. The consensus was that if we were going to suffer this God-awful heat, at least we could have bragging rights about it. We could get old and sit around toothless and diapered and bellow about the summer of 2011. But nooooo.
Oh well, while I mourn the loss of our hotness record, I was asked to comment about an article on hypochondriacs. Hypochondria is a medical condition in the family of OCD and depression, and apparently it costs the human medicine field billions of dollars. The internet and TV haven’t helped.
I’ve watched an episode or two of House and I always end up screaming at the television. The guy comes up with all these random ridiculous theories and diseases seemingly at whim. His thought process is ludicrous. Some sick girl rolls in with a paper cut and he’s all, "Look at the dirt on her shoes, that’s African dirt! Clearly she’s got Ebola and needs to be quarantined immediately or we’re all going to die!"
The old TV show ER caused me more than a little concern, as I am easily swayed to fits of minor hypochondria at times. I never get hiccups without worrying that I might have fatal diaphragm cancer, like some lady in an ER episode.
Grey’s Anatomy is another show with more than its share of medical melodrama. I quit watching when Denny died. He was a young, handsome, rich dude who got some random infection and needed a heart transplant (because THAT happens every day). He was in love with Izzy, and Izzy loved him. Izzy orchestrated a series of events that got him a new heart, and they make you think he’s going to live happily ever after, and it’s all warm and fuzzy, and then BAM, he keels over dead from a blood clot. I will never forgive that show for toying with my emotions that way.
Every now and then I catch an episode of Grey’s at the gym and it seems like somebody is always waving a gun around the hospital and some staff member gets shot. I’m surprised it hasn’t triggered a wave of hospital-shooting-phobia.
So our world is rife with terror. If you let yourself get bogged down in the minutiae of your every malady you can go nuts. God knows I’m the queen of the worst case scenario when it comes to my kids. My kid had a cold with a fever once, and I called my doctor because I got it in my head that he had vegetative endocarditis. She thought I was nuts. A weird little ache in my belly became appendicitis (in my head) and resulted in a medical saga that culminated in an abdominal CT that left me convinced that I had just peed in my pants (turns out it was a side effect of the contrast medium that they neglected to warn me about).
I see it in my branch of the medical field, too. One of my favorite clients’ little dogs got a papilloma on his foot (basically a wart). She came to me, after exhaustive Internet research, with tears in her eyes and asked me if he was going to die. Luckily I knew her really well, so my exasperated "are you kidding me?!" response didn’t upset her. I talked her off the cliff and she doesn’t hit the web quite so extensively now.
The point is: The web is FULL of REALLY SCARY information. All you have to do is look.
One of my best friends said that if you look around every corner for trouble, eventually you will find it. I see it relatively frequently with clients. They get themselves caught up in this cycle of watching their pets seemingly non-stop, looking for the next problem. They are frequent visitors to the office, always with a new list of issues. Hours are spent on the phone discussing them. Just like on the human side, it’s exhausting for both parties; one side desperately trying to convince the other that there’s a serious problem. The other side examines, run tests, listens, then slowly starts to think that their adversary might just be nuts.
I swear, sometimes the clients make their pets sick by obsessing about them so much. The animals sense the human’s stress and scrutiny. I’d act weird too if someone was watching my every move and fretting over it.
What I want to know is where do you draw the line? How do you know that the person is just a hypochondriac and not actually sick? What are the odds that they/their pet actually do have some rare disease that House could figure out with a hair sample?
I’ve only seen one case where the client was truly mentally ill. He was an older man who was convinced that his cat was covered in worms. He shaved the poor thing and came in almost daily for us to dip/spray/disinfect the cat. We couldn’t see anything. We tried everything (anyone remember the story in one of the James Herriot books about the lady who brought in a paper mache dog to be treated for fleas? Dr. Herriot sent her home with some talcum powder and everything was hunky-dory). Nothing convinced this guy that his cat was not full of writhing worms. In desperation we were going to try and send him to the specialist. I called our local dermatologist ahead of time and he told us "no way" were we sending the guy to him. The client had [insert name of mental illness that I’ve forgotten] and had to be dealt with directly. We had to tell the poor old guy that the cat wasn’t full of worms and we quit pandering to him.
We don’t fire the hypochondriacs (as mentioned in the article), but we do refer them. Especially when all the tests are negative, the pet looks normal, and the phone calls are unrelenting.
Maybe someone with a bigger brain can solve the problem. That, or the client will eventually run out of money. Or find a new vet to torment.
Dr. Vivian Cardoso-Carroll