Susanna Agardy
On 4 August I posted an article on Medically Unexplained
Symptoms. (Medically Unexplained Symptoms = Failure to Diagnose
http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0908a&L=co-cure&T=0&F=&S=&X=3CF3977FD788764B10&Y=susannaa%40dodo.com.au&P=2204
) This was the text of an e-mail I sent to Dr Monica Greco in
response to her statements in the BBC4 radio programme Thinking
Allowed on 1 July.
I have received a reply from Dr Greco in which she explains her
position and indicates that the interview did not properly reflect
her position. She is anxious to clarify her position and she has
agreed for me to post part of her reply.
While I believe my comments apply to MUS I do not wish to extend Dr
Greco's position further than she intended. The relevant part of Dr
Greco's reply is as follows:
"My argument really makes no assumptions about causation and focuses
on a different question, namely: how we collectively (as doctors, as
patients, as a society) relate to forms of illness we cannot (yet)
diagnose and/or explain. Should an explanation be a sine-qua-non for
the purpose legitimating care? What does it mean to care in the
absence of a scientifically valid explanation, on the basis of
symptoms alone? And are there ways in which the privilege accorded
to aetiology in our thinking may actually hinder the delivery of
better care in many situations?
My suggestion on the radio programme was not that "sympathy" should
substitute for rigorous research on the possible causes of conditions
such as ME. My suggestion was rather that, in many primary care
situations, the immediate focus on physical investigations and
treatments often constitutes a "knee-jerk" reaction dictated by
factors that have little to do with the best interest of the patient.
Indeed, physical evidence - or lack thereof, as supposedly "proved"
by negative test results - is often used to better dismiss patients
and their concerns rather than vice-versa."
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