Doctors Don’t Know Anything

My apologies for slacking on writing posts recently…little preoccupied with my own life, but we’ll get to that in another post perhaps. Today, though I wanted to discuss doctor’s lack of knowledge about so much! Recently I saw my neurologist and had a follow-up MRI for the MS symptoms I experienced last year. A year ago, I had an MRI that showed multiple lesions, and a few weeks ago, I was told by my doctor that most of the lesions were gone and there was nothing new! Great news, right? Here is the conversation that my doctor and I had:

Doc: So your MRI looks a lot better…a lot of the lesions are gone…
Me: You sound surprised. Is this what you were expecting in the course of treatment?
Doc: Well, sometimes this happens…
Me: Do you think it’s the medication I’ve been taking?
Doc: Perhaps…
Me: Do you normally see this in MS after starting treatment?
Doc: In some cases…
Me: Can you tell me anything definitive?
Doc: Possibly…

Ok, the last two lines were made up, but you get the idea. My doctor really could not tell me whether I am getting better because of the medication I am taking, the lifestyle changes I’m making, the cinnamon I’m eating, or just the course of the illness. I do understand that MS is an unpredictable illness and often times it is difficult to predict whether symptoms are related to specific findings, as well as response to treatment. In fact although I complain (from a patient standpoint) I also have the perspective of a physician. As a psychiatrist, there are many unknowns about mental health, including its etiology, let alone its treatment. We rely on research studies for evidence-based treatment options, but sometimes there just isn’t any data. We then have to rely on our own or others’ clinical experience to guide us. I often start patients on antidepressants, and the patient improves. Did the patient improved from a placebo effect, the medication, the support and counseling, or even exercise? Hard to say in some cases.

Despite my questions, I am of course happy to be doing better. I feel confident enough that the medication I am taking is helping to some degree, so I will continue to take it. But it’s just a guess.

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One Comment on “Doctors Don’t Know Anything”

  1. I.B. Says:

    Very interesting, Doc! Whatever you’re doing, seems to be working!


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