Symptoms of Unknown Origin: A Medical Odyssey

Clifton K. Meador M.D.9780826514738, 0-8265-1473-1, 0-8265-1474-X

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.

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Table of contents :
Cover……Page 1
Contents……Page 6
Acknowledgments……Page 8
Introduction……Page 10
Prologue……Page 18
1. An Unlikely Lesson from a Medical Desert……Page 22
2. Texas Heat……Page 32
3. Dr. Drayton Doherty and Miss Cootsie……Page 37
4. All Some Patients Need Is Listening and Talking……Page 44
5. Diagnoses Without Disea……Page 50
6. The Woman Who Believed She Was a Man……Page 57
7. Mind and Body……Page 66
8. Sweet Thing……Page 72
9. New Clinical Interventions……Page 78
10. Florence’s Symptoms……Page 83
11. Symptoms without Disease……Page 98
12. Looking Back on Fairhope……Page 112
13. The Diarrhea of Agnes……Page 119
14. Dr. Jim’s Breasts……Page 125
15. The Woman Who Would Not Talk……Page 131
16. The Woman Who Could Not Tell Her Husband Anything……Page 141
17. Staying out of God’s Way……Page 150
18. A Paradoxical Approach……Page 159
19. You Can’t Be Everybody’s Doctor……Page 167
20. In Tune with the Patient……Page 172
Bibliography……Page 182
Index……Page 186