Monday, September 17, 2007

What Did Tornadoes Sound Like Before Freight Trains Were Invented?

About 20 or so years ago I had a friend who, every time I saw her, had something else wrong with her. There was always some physical malady bothering her and keeping her from enjoying life to the fullest. She had gone through an entire list of stuff happening to her from bowel problems, to gallbladder trouble, to endometriosis until one day she told me she had TMJ

She was speaking about the diease tempormandibular joint syndrome, which would actually be TMJS, but I'm saving annoying English and grammar for another post. In medical terminology TMJ refers to just the joint, hence the J.

But I digress.

At that time I had never heard of TMJ. I was, and always have been, interested in medicine, so I was instantly fascinated and wanted to know more. Since the Internet wasn't around much, or not to the typical person like me, I had to find out more on my own. I hadn't even made it to the library before I saw an article about TMJ in a ladies magazine - Redbook, Ladies Home Journal, something like that. Turns out it is fairly common and lots of people have it and the treatment is fairly simple.

What is interesting to me now about this malady is that this was the first time I experienced a phenomenon that I now see all the time. There is a new disease discovered or brought to the public's attention and suddenly everyone has it. I remember when everyone had hypoglycemia, then it was carpal tunnel syndrome, then chronic fatigue syndrome, then dysautonomia, then sleep apnea, and now restless leg syndrome.

I know there are people who really do suffer from these conditions, and for those people I have a great deal of compassion. It just seems to me that there are a lot of people who have these complaints and really don't have anything wrong with them, but want to use the disease a way of drawing attention to themselves or to get out doing stuff they don't want to do.

In nursing school we are talking about mental illness. This week we talked about somatoform disorders. These are disorders for which there is no physical evidence of illness. Some of the disorders cause actual physical pain and other symptoms for the patient. Others are completely manufactured by the patient to get out of having to do things they don't want to do, to get money via lawsuits or disability, or because they enjoy the sick role and want attention. This called malingering and it's different from other disorders in that the patient knows they don't have anything wrong with them, and the goal of being "sick" is personal gain.

It happened again the other day. When I was at the psych hospital an adorable, tow-headed, blue-eyed lad of 19 years told me he didn't sleep the other night because he had restless leg syndrome. Restless leg syndrome? Son, you are all of 19. Most people with this disorder develop it in middle age, so go sit down and do your homeowrk. Five years ago nobody had restless leg syndrome because it hadn't been invented yet. Now everyone has it.

My question is what did you have before there was TMJ? Did you just have a headache or an odd clicking noise in your jaw? Before there was restless leg syndrome were you just amped up on Red Bull or going through the manic phase of your bipolar disorder?

It's not just malingering that motivates people into having sexy new diseases. I blame TV as well. Now that it has become legal for pharmaceutical companies to advertise on television, it has done so much to make people believe they are ill and must have the sexy new drug they saw on TV. It works the way advertising works - create a need, tell people they are flawed in some way and then sell them the solution to their problem. The transition for using this technique to sell drugs is seamless.

There was an episode of Scrubs recently where two of the characters are sitting on the couch watching television. The dialog pauses and the newscaster is telling of an outbreak of a new bacteria in the city. The two doctors sit upright and scream NOOOOOOOOOOOOOOO!!! In the next scene the hospital is being overrun by people who think they have this new bacteria.


People are already overly hysterical about everything anyway. Again, I blame the media for this. The media takes a simple fact and presents it with earnestness and anxiety to make it seem like it's a horrible problem, when it's something normal and natural. For example, giardia. Now that is one unattractive parasite and what it does to you will make you feel not at all sexy. You will have cramps, bloating, gas and frequent, watery diarrhea and there is simply no way to sex that up. So let's say in your part of the country there are typically 10 cases of giardia a year. It's not such a big deal. That might be a pretty good number now that we have sanitation and water treatment plants. The number was probably much higher 100 years ago, but we don't know because maybe statistics weren't kept in your part of the country 100 years ago.

So the media gets hold of this number and screams OH MY GOD!!!!!! THERE WERE 10 CASES OF GIARDIA REPORTED LAST YEAR!!!!!! IS THE HEALTH DEPARTMENT DOING ENOUGH TO PROTECT YOUR FAMILY!!!!!?

I never hear of anyone using giardia as an excuse for getting out doing things they don't want to do. No one ever claims they have West Nile virus, or luekemia, or multiple sclerosis. No. Those are not sexy diseases.

And what of all the sexy diseases of the past? Why doesn't anyone have the dropsy anymore? Or the ague? Or the consumption? Because now they have edema, fever and chills, and tuberculosis and it doesn't sound nearly as exotic or interesting. All of these old disease aren't as sexy anymore, or maybe the newer diseases are sexier, easier to have, harder to diagnose, and just bad enough to get you out of going to work or school but not bad enough to disfigure you are cause you horrible discomfort.

What horrible disease lurk on the horizon? I can't write about it anymore because I've developed a terrible case of texting thumb and I have to go lie down on the couch for the rest of evening. I might even have to take a few days off work until I feel better.

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