I have had some great doctors, but one of the things that I have learned from all of them is that I must be heavily involved in diagnosis. For instance, recently I went to talk to my doc about being tired all the time. He looked at my weight and immediately decided that I needed a sleep study. He assumed sleep apnea. I felt very strongly that he was looking at the wrong thing and finally insisted on blood tests. It turned out to be a Vitimin B12 deficiency. We started me on a series of shots: 1 per day for a week, 1 per week for a month and now 1 per month.
I’m pleased to say that - although I do hit a wall occasionally - I now have more energy and feel better than I have in several years.
The point of all that typing is: Humans have symptoms that could be attributed to many diseases. Sometimes a doctor will get lucky and know which one to look at first. Other times he will have to go through several scenarios, just like on House.
Absolutely. I don’t think it’s a bad thing for US to be googling stuff, and being responsible for making some decisions on our own health. The days of doctors sitting down with a patient and asking the same question three different ways are long gone, here, I’m afraid, WhyNot. You wait two hours to see the doctor, and he spends two minutes with you, without actually looking at you once. That’s probably one of the reasons my intermittent stomach pain has continued to remain undiagnosed.
I felt so proud when the “disease of the week” turned out to be something that one of my brothers has. Fortunately, his was diagnosed fairly quickly and it’s not a huge problem for him. He gets to go to the Mayo Clinic for check ups now. He can just call them up and ask for an appointment.
Now if anyone can cure his retinal hemorrhaging, then you can win a prize. That was fairly easy to diagnose, but it’s really hard to cure.
Yep, it’s been tried. A lot of focus on artificial intelligence in the 80’s was on medical diagnosis. There were some successes, but it’s a hard problem for a lot of technical reasons (and some sociological reasons, e.g. getting doctors to actually use the programs). It’s been fifteen or 20 years since I was even slightly current on the progress in the field, but some of the issues are:
a. Keeping the hypotheses down to a reasonable number. There are thousands of diseases and many of them have very similar symptoms. Really, the body has a lot of ways to go wrong but only so many ways to hurt.
b. Handling probabilities. As a consequence of (a), a diagnosis is rarely a yes/no sort of thing. You assign probabilities to various outcomes based on the results of tests and perform operations on the resulting probabilities to come up with a list of possible diagnoses. There are many issues here, one of which is actually coming up with good enough and complete enough statistics to generate reasonable decision trees.
c. Producing a human comprehensible chain of reasoning. A computer can’t just pop out a diagnosis and have it taken as gospel. You have to produce the chain of reasoning that led to the diagnosis. Often the knowledge in the program isn’t represented in a way that’s convenient for doing that. (For example, consider the 20 Questions electronic game that tries to guess an object based on a series of yes/no questions. Often the questions seem weird and opaque and you wonder how they ever led it to the right answer.)
Odd story: I had my tonsils taken out in about 1970, and not in a hospital, but in a suburban shopping mall.
Our family doctor had his office in the mall for several years. When I was about 14, he determined that my tonsils should come out. He did it himself a few days later, right there in one of the rooms in his office. It was done as an outpatient procedure, of course. We went in fairly early in the day, had the surgery, and went home late in the afternoon.
Over the years, I’ve come to decide this was sort of out of the ordinary. Every medical person I’ve mentioned it to thinks it’s strange. But at the time I didn’t think anything about it. I’d never been in a hospital for anything, so it just didn’t strike me as odd to not go for this.
And to the OP, my wife and I love House. The total lack of empathy for the patients, and treating them like tinker-toys that exist solely for his amusement is what makes it fun. Not realistic in the least IMHO (although I’m not a medical person of any kind) but funny. I hope they don’t use the recent story arc to make his character into more of a touchy-feely sympathetic type. It would totally ruin it for me.
Hmm. Even odder story. Harpo Marx had to have his tonsils out but didn’t have enough money. Someone sent him to a dingy office where a “dwarf” (his word, with a hunchback, IIRC) clipped them out, then tried to sell him pornographic etchings. Years later, when Harpo saw regular MDs, they’d always comment that the tonsillectomy was very well done.
My bigger problem with House is that the titular House seems to have ridiculouly broad medical knowledge. I don’t care how smart he is, he seems to have encyclopedic information on exotic diseases from every field which exists. And often mocks people for not being equally supernaturally brilliant.
Read Gilda Radner’s “It’s Always Something” and Fran Drescher’s “Cancer Schamcer” about the struggles both women went throught to be diagnosed with ovarian cancer–similar symptoms, multiple doctors before they finally got treatment.
Yeah, reminds me of a phrase I learn while working with a vet, Common things happen commonly. I was really suprised by how many diseases have similar symptoms.
In the same way that they don’t show you House having a crap every morning just before breakfast, they also don’t show him studying up on likely diseases while his minions are away conducting tests.
I haven’t seen that many episodes, but I do remember that some of them feature shots of House searching old medical journals over Lexus-Nexus (or somesuch) to see if he pings anything.
But yes, he does get flashes of insight that seem to come out of nowhere sometimes. But he gets to do that because he’s the main character.
