So You Want An Online Diagnosis?

Last week Doctor D sternly rebuked those who wanted him to answer illegal (diagnose-me-over-the-internet) questions.

Several commenters replied it was D's own fault for naming his blog "Ask An MD." I mean seriously, what answers could an MD possibly have worth reading if he can't discuss your bowel problems?

Oh, so THIS is what you wanted?

So "Ask An MD" is running a special this week only:

Doctor D will answer every single diagnosis or treatment question you ask in the comments of this post!

(Very important small-print disclaimer: None of Doctor D's answers will be correct or sensible in any way )

What good are bullshit diagnoses, you may ask?

The Weight of Perfection

One of the greatest stresses in a doctor's life is having to be correct all the time. Of course, we aren't always correct, but people always expect us to be correct. This leads to a lot of stress in a docs life.

The avalanche of questions started early:

When Young D was a Pre-medical student in college people started asking him questions that were totally beyond his abilities. "Hey D, I get this weird feeling in my stomach, but sometimes it isn't there. What is that?"

Ah, to be young and free of the heavy responsibilities of doctoring!

D would just smile, shrug, and say, "Probably either metastatic cancer or gas."

Young D became legendary for his smart-ass diagnoses, and a good time was had by all.

But then Medical School began and the game of diagnosis became one of life and death. A wrong guess could hurt someone—badly. People kept throwing unanswerable questions at him, but the weight of his profession had crushed D's carefree attitude. He began giving evasive responses and advising people see their own doctor.

D has been practicing medicine for a while now. It is heavy stuff to talk to people every day about the ways that their own bodies can cause misery or kill them.

Doctor D actually doesn't like talking about suffering and death. He would rather open your mind and make you smile. So D started this blog answering people's questions about the odd quirks of the medical profession. For D this blog is a lighthearted way to process the hard and nasty stuff he has to see every day at work.

But work found Doctor D in his secret online hide out. He should have expected it—answering questions about doctors brought patients, and patients have questions about diseases they want to ask doctors.

Unfortunately, I can't answer diagnosis or treatment questions, no matter how desperate you are. I have to admit: I don't even want to try. I miss sleep at night over the guesses I make in my real job. Trying to do the same thing on-line would lead poor Doctor D to have a nervous breakdown.

But Doctor D won't abandon you poor folks so desperate for answers. He can't diagnose you but he can offer you the next best thing: Utter Nonsense!

"Nonsense Therapy is all-natural and involves no harsh chemicals!"

Therapeutic Misinformation

Do you doubt the healing power of ridiculous bullshit?

Doctor D learned this lesson as a young doctor. He had been working for months with a patient who was miserable from one of those frustrating mystery illnesses. She was in the office crying and listing her symptoms. Finally Doctor D shrugged and grinned, "All I have left to offer you is racehorse therapy. We take a rifle and put you out of your misery!"

At first Doctor D was petrified. He had let one of his pre-med smartass comments loose on a real person with real suffering! Then the patient smiled—the first smile he’d seen from her in months. Then she laughed, and D laughed with her. They had a good hearty laugh and the patient hugged him as she left the office.

Things were different after that. We talked and laughed a lot. We never found a diagnosis for her, but we ridiculed the disease mercilessly. It made us both feel better.

Nonsensical bullshit from a doctor can have a wonderful therapeutic effect!

Ask any middle-schooler and they will confirm it: The human body is funny! The human body is silly! The human body is gross! The human body is ridiculous! The human body is a low-down Judas that will eventually screw you over then kill you!

The only sensible thing to do is to mock our bodies on a regular basis.

So send Doctor D your symptoms and he shall mock them fiercely! He shall diagnose you with improbable and silly things! He shall loose his inner child to laugh at your bodily functions! He shall suggest ridiculous and painful treatments!

Not a single one of you shall get any useful medical information from Doctor D’s snarky replies... but you still know you want to send D your symptoms!

Therapeutic Misinformation:

Just like Chiropractics!

It feels so good,
you won’t even care that it’s total bullshit!

All questions will be personally answered by the doctor. So send in those aches, tingles, throbs, swellings, and vaginal discharges!

Now, Doctor D is a busy man, and he doesn’t check his email 8 times a day like more dedicated medbloggers. (Grumpy you're embarrassing the rest of us with your annoying dedication!)

Be patient, and the doctor will be in to misinform you and mock your symptoms shortly!

Health Info Online (That Isn't BS)

A question from a reader:

I’d like to know where I can go for trustworthy information on a diagnosis when I haven’t got an appointment in the near future.

Fortunately we live in the Information Age and you are sitting in front of a computer right now with an ocean of information at your fingertips. The “trustworthy” part is what poses a problem.

There is some crazy “medical” information on the web. Some suggestions are obvious quackery, such as saying that goji juice cures every illness known to man. Some erroneous advice may not be as obvious. There is a lot of money in healthcare, and you don't need any scientific evidence to get access to the big dollars—just ask a chiropractor! There are also a lot of well-meaning people who want to share advice that may or may not really work, like your grandma who was sure that a teaspoon of castor oil would cure anything.

You can start with asking your doctor. A specialist may have a specific site they recommend for your condition. For general information Doctor D typically sends his patients in the direction of familydoctor.org and UpToDate for Patients.

Tips for sorting through the medical information on the Internet:

• Print out what you find and take it to your doctor who can often tell you if it is reputable. Doctor D has researched some very interesting topics because his patients brought them in.

• If it sounds too good to be true it probably is. The more conditions a treatment supposedly fixes the more likely it actually works for nothing at all. This is particularly true of nutritional supplements and “natural” medicines, whose claims are almost totally unregulated.

• Remember that every individual is different. Patient forums can be an excellent way to connect with others in the same situation as you, but the experience of someone else with your condition cannot always be applied directly to you.

• Remember the placebo effect is powerful. Unproven treatments often appear to “work” due to the placebo effect combined with the body's natural ability to heal itself. If a treatment has never been tested against a placebo it is hard to say if it really works or not.

• Consider the source of your information. Who is it and what is their motivation for giving you this info? Big pharmaceutical companies often create “educational sites” whose purpose is to interest you in their drug. Any very nicely-designed site that reminds you to "Ask your doctor about ___" probably stands to make money off what your doctor might prescribe.
  

• Keep in mind that big news/entertainment names are selling drama which often isn't the same as trustworthy medical information. Don't trust everything you hear from Oprah!

• Never take advice from anonymous sources! I mean, what sort of doctor would blog without using his real name? (Just joking. But this is one reason Doctor D doesn't give treatment or diagnosis advice on this blog!)