Patient, Help Thy Physician

Clifton Meador, M.D., practiced medicine and taught young doctors for years at Vanderbilt, Saint Thomas and Meharry. Throughout that distinguished career he has been particularly interested in unusual, even bizarre, cases, and he advises doctors and patients alike to approach medical diagnoses by considering the whole patient, both mind and body. His latest book, Puzzling Symptoms (Cable Publishing, 125 pp., $12.95), is directed primarily toward the patient half of the doctor-patient relationship.

Physicians today work in an age of technological marvels, and Meador is as awed as anyone by the space-age instrumentation that allows a doctor to see inside patients without cutting them open first. But he also believes that listening is an essential tool in diagnosis—a tool that's insufficiently used in the 21st century: "Medicine's over-reliance on seeing has led to a decline in physicians listening," he writes. Besides peeking at a patient's insides, a doctor ought to be asking questions: What is the patient eating, feeling or doing that may be contributing to his symptoms?

With Meador's background in "difficult" patients, he has good reason to be wary of the easy diagnosis, or even the belief that symptoms must be caused by illness. For Meador, "there is a demonstrable cause for every symptom," but that cause may not be a disease. So he insists that patients assist the physician in listening for causes of aches and pains that may be missed or misdiagnosed. His principal advice is to keep a symptom diary that tracks the environment—diet, activities, surroundings—in which puzzling symptoms occur.

As with Meador's 2005 book, Symptoms of Unknown Origin, which was directed primarily at doctors, some of the most interesting sections of Puzzling Symptoms are its descriptions of cases in which people are initially misdiagnosed. Incidents such as "A lesson from a young girl with diabetes" and "Mrs. Oliver Townwell's life in a wheelchair" provide wonderful illustrations of the fact that human beings are all creatures of their environment—and often the key clue in solving the puzzle of their illnesses.