[Health Column] The Trap of Major Diseases

[Asia Economy] Even if the pain is in the same area, the disease names have become much more detailed compared to the past. There was a time when diagnoses and treatments were made with just a few diseases. If the back hurt, it was a herniated disc; if the stomach hurt, it was enteritis; if the head hurt, it was high blood pressure, and so on. However, now even for the back area alone, disease names have diversified into spinal stenosis, foraminal stenosis, spondylolysis, spondylolisthesis, and more. Nevertheless, many patients still confine themselves to a few representative disease names. Patients who visit due to back pain ask if they have stenosis even before the consultation. Most people with shoulder pain think they have a rotator cuff tear. Patients with knee pain resign themselves to the idea that it is due to worn cartilage and that nothing can be done beyond painkillers.

There are several reasons why patients tend to label their pain with these representative diseases. First, indirect medical information has become abundant. Without going through a direct medical consultation, patients self-diagnose their illness based on numerous pieces of information circulating on the internet and mass media, and decide on a disease name. Second, when patients visit multiple medical institutions and receive the same diagnosis, they tend to believe that diagnosis is correct. Especially when the diagnosis comes from a renowned doctor at a large hospital, the trust level is higher. Third, when visible evidence is presented. If a herniated disc is seen in an image or a narrowed knee joint due to worn cartilage is visible, that disease is imprinted in the patient's mind.

The author considers the above cases as a 'trap' for a reason. Occasionally, patients in serious conditions recover through treatment for representative diseases. However, some patients who are difficult to treat with representative disease diagnoses become reluctant to undergo active diagnosis and treatment because they are trapped by their own fixed ideas. These patients are misled into thinking they have a well-known disease (representative disease) that is difficult to treat, even though their condition could be easily cured by looking for a slightly different cause. Unfortunately, such cases can be said to be patients who have fallen into their own trap.

Patients trapped by their own fixed ideas are difficult to treat. They cannot express their own stories. They cannot describe where they are uncomfortable and say things like, "I have a herniated disc at levels 4 and 5." They convey what they heard at the hospital instead of their own symptoms. Some even say, "My disc hurts." Moreover, these patients dislike re-diagnosis itself. They have already visited several places, spent a lot of money at a large hospital to get images taken, and were diagnosed with a herniated disc, so they refuse to undergo physical examinations. They stubbornly demand only the same treatment they received there. It is regrettable and frustrating.

Since diagnosis can have a significant impact on patients, medical staff must reconsider it multiple times. They should also keep the possibility of other diagnoses open and provide detailed explanations. It is easier for doctors to know fewer diseases. If they do not know various treatment methods, they do not have to worry, which is also comfortable. However, doctors must never become accustomed to such comfort. If doctors mechanically confine patients to a few representative diseases, patients become trapped in that frame and cannot escape. Primarily, this is the fault of the medical staff, but patients must also break free from the frame of representative diseases. This is especially true when the prognosis of treatment for representative diseases is poor.

Park Yongseok, Director of Haengbok Anesthesia and Pain Medicine Clinic