Symptoms of Unknown Origin: A Medical Odyssey
“It was a ‘can't put it down’ book.”
For years after graduating from medical school, Dr. Clifton K. Meador assumed that symptoms of the body, when obviously not imaginary, indicate a disease of the body—something to be treated with drugs, surgery, or other traditional means. But, over several decades, as he saw patients with clear symptoms but no discernable disease, he concluded that his own assumptions were too narrow and, indeed, that the underlying basis for much of clinical medicine was severely limited.
Recounting a series of fascinating case studies, Meador shows in this book how he came to reject a strict adherence to the prevailing biomolecular model of disease and its separation of mind and body. He studied other theories and approaches–George Engel's biopsychosocial model of disease, Michael Balint's study of physicians as pharmacological agents–and adjusted his practice accordingly to treat what he called “nondisease.” He had to retool, learn new and more in-depth interviewing and listening techniques, and undergo what Balint termed a “slight but significant change in personality.”
In chapters like “The Woman Who Believed She Was a Man” and “The Diarrhea of Agnes,” Meador reveals both the considerable harm that can result from wrong diagnoses of nonexistent diseases and the methods he developed to help patients with chronic symptoms not defined by a medical disease. Throughout the book, he recommends subsequent studies to test his observations, and he urges full application of the scientific method to the doctor–patient relationship, pointing out that few objective studies of these all-important interactions have ever been done.
“This book is about thinking outside of the box when confronting human illness. It consists of a collection of very entertaining medical enigmas from Dr. Meador's career that serve as parables to illustrate the inadequacies of the prevailing "biomolecular" approach to understanding and treating illness.
Although the biomolecular model of Dr. Meador's day has since been supplanted by the biopsychosocial model in academic circles, in actual clinical practice this transition has yet to occur. Instead of searching for root causes, we learn to blame our patients for their refractory illnesses by characterizing them as "problem patients", "difficult", or "noncompliant". Those labels are often true, but they don't encourage or help us to address the underlying problems. Dr. Meador's book does.
Whether you're a dedicated "never-give-up" doctor who wants to help even your most trying patients, a frustrated clinician who is sick of losing battles with chronic disease day in and day out, or simply a perceptive soul who snickers at the thought of trying to reduce a whole patient into a set of ICD-9 codes, I think you will find this instructive and compassionate little book to be full of insights that will make it worth reading and re-reading on a regular basis.”
“This book, Symptoms of Unknown Origin, was fascinating. The author, Dr. Meador, tells about his working with and learning over time with patients who seem to have no origin for their diagnosis. Using the skills of a neurolinquist he sharpens his ability to find causes where none seem to exist, and such causes are often outside of the medical field. It was a "can't put it down" book.”
“Dr. Meader uses case studies to consider how physicians can recognize and treat patients with symptoms hitherto deemed 'imaginary' or unconnected to disease. These case histories are bizarre and unique, but go a long way in illustrating how diagnoses can easily be wrong, and how the methods Dr. Meador developed to diagnose 'nonexistent' diseases can help physicians consider diagnosis more fully. Dr. Meader urges subsequent studies to test his observations, but the real meat here lies in case history examples which are eye-opening surveys of uncommon medical health and disease indicators. ”
Midwest Book Review
“I am proud to claim Cliff Meador as a friend and mentor throughout my medical career, and this book will show you why. It's funny, brilliant, and gets at the heart of the practice of medicine: the intimate, important interactions between doctor and patient, science and humanity, suffering and healing. More than anecdotal, this ought to be required reading for every medical student, and for anyone who's ever been a patient. ”
Mary A. Harbison