Symptoms of Unknown Origin: A Medical Odyssey

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Vanderbilt University Press, 2005 - Medical - 175 pages
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For years after graduating from medical school, Dr. Clifton K. Meador assumed that symptoms of the body, when obviously not imaginary, indicate a disease of the body--something to be treated with drugs, surgery, or other traditional means. But, over several decades, as he saw patients with clear symptoms but no discernable disease, he concluded that his own assumptions were too narrow and, indeed, that the underlying basis for much of clinical medicine was severely limited.

Recounting a series of fascinating case studies, Meador shows in this book how he came to reject a strict adherence to the prevailing biomolecular model of disease and its separation of mind and body. He studied other theories and approaches--George Engel's biopsychosocial model of disease, Michael Balint's study of physicians as pharmacological agents--and adjusted his practice accordingly to treat what he called "nondisease." He had to retool, learn new and more in-depth interviewing and listening techniques, and undergo what Balint termed a "slight but significant change in personality."

In chapters like "The Woman Who Believed She Was a Man" and "The Diarrhea of Agnes," Meador reveals both the considerable harm that can result from wrong diagnoses of nonexistent diseases and the methods he developed to help patients with chronic symptoms not defined by a medical disease. Throughout the book, he recommends subsequent studies to test his observations, and he urges full application of the scientific method to the doctor-patient relationship, pointing out that few objective studies of these all-important interactions have ever been done.
 

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Contents

Prologue
1
An Unlikely Lesson from a Medical Desert
5
Texas Heat
15
Dr Drayton Doherty and Miss Cootsie
20
All Some Patients Need Is Listening and Talking
27
Diagnoses Without Diseases
33
The Woman Who Believed She Was a Man
40
Mind and Body
49
Symptoms without Disease
81
Looking Back on Fairhope
95
The Diarrhea of Agnes
102
Dr Jims Breasts
108
The Woman Who Would Not Talk
114
The Woman Who Could Not Tell
124
Staying out of Gods Way
133
A Paradoxical Approach
142

Sweet Thing
55
New Clinical Interventions
61
Florences Symptoms
66
You Cant Be Everybodys Doctor
150
Bibliography
165
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About the author (2005)

Clifton K. Meador, M.D., is Clinical Professor of Medicine at the Vanderbilt School of Medicine and Meharry Medical College as well as director of the Meharry Vanderbilt Alliance. He is the author of eight books, including A Little Book of Doctors' Rules and Med School: A Collection of Stories of Medical School, 1951 to 1955.

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