Template Medicine

In what is perhaps a harbinger of things to come, I offer you the pain in my back that I have had for the last 20 years. Orthopedic, chiropractic, and family medicine dudes have all heard me complain about the severe pain in my lower back. X-ray after x-ray showed nothing. Finally, one guy came up with the only diagnosis from any of these guys. He said I had “butt pain.” I dutifully paid him my $75.00, and went forth.

But over the past 6 months, it has ceased being a laughing matter. My body has developed a twenty degree tilt to the right, and it is impossible to straighten my body out. When I try to straighten out, I have to lift my right off the ground at least an inch in order to align my hips with my spine. In addition, the pain has become unbearable. I have been unable to lay down now for close to a year. On some days I can barely walk. Even scarier, severe neuropathy has developed in both legs, and now is rapidly descending into my arms and hands.

My GP sent me to a neurologist. He stuck me with pins and shocked me all over my body with what looked like a miniature cattle prod. It was painful. But he never talked to me, instead he handed me off to his “nurse practitioners,” who were nice... but insisted I was diabetic and completely ignored the debilitating pain in my back. When I pointed out the spinal tilt to the right, they yelled at me to stand up. They refused to hear me when I told them I couldn’t.

Finally, one of them got the bright idea that maybe I should have an MRI. Duh!!! It showed I had a cracked 3rd vertebrae that had been broken for a long time, or continually healed and then broke again. The thought that maybe the pain in my back and the loss of feeling in my legs might be related didn’t faze them. They repeated they were going to treat me for diabetic neuropathy, gave me a 6 month supply of anti-depressants to treat it, and told me to come back in six months. I asked to speak to the doctor, and they did give me an appointment…on April 30.

I returned to my GP, and told him that these guys were all wet. He tested me for diabetes…and found none. When he saw the tilt in my spine, he referred me to an orthopedic guy, who immediately questioned me about diabetes. He never really observed the tilt in the spine. He completely ignored the excruciating pain in my back, and glossed over the fact that a lift in my right shoe and wearing a thick slipper on right foot at night gave me a degree of relief. I asked if it ever occurred to him that my right leg may be substantially shorter than my left, and that may be the source of the problem? He said that wasn’t the case, and any relief I felt with a lift in my right shoe was only a “quick fix”. He opined nothing, and told me to come back in a week.

I know these guys, and they are all good guys and conscientious and caring doctors. But after watching how they were handling me, and how others handled my mother, and how they handled my father, I have come to the conclusion that most doctors practice “template medicine.” I suppose this is nothing new to most of you, but it is new to me. You either fit into one of several slots, or you are on your own. If your symptoms stray too far afield from whatever diagnostic templates to which the doctors subscribe, you are plain out of luck.

Watching the health care debate in Congress, I can’t help but think this is predictive of things to come. The government will provide codes for mass diagnoses, and if you don’t fit the bill…good luck to you.

Update: The orthopedic guy is sending me to therapy to assist me with the curvature in my spine. He told me the crack in my spine was acute, there is not a whole he can do about it, and it will take a long time to heal. At least we are making some progress.