Friday, June 17, 2016

An avalanche of data buries the patient story

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I was really anxious.  My father’s legs were getting weaker and his pain was worsening.  He had been having pain for quite a while, and that pain was often disabling in its severity, but the weakness was alarming.

Dad went to the neurosurgeon, who was also alarmed at the weakness, but didn’t feel that the problem was surgical in nature.  When I heard this I broke one of my most tightly-held tenets: don’t get involved in my family’s care.  I wrote a letter explaining the narrative of my dad’s condition and why I was immediately concerned.  It did the job; he got a study, was seen again by the neurosurgeon, and is now one day post-op for the treatment of his severe lumbar stenosis (narrowing of the canal).  It’s just day 1, so the jury’s still out, but he’s doing great.

The obvious question arises with this story: Why did I see much greater urgency than the neurosurgeon?  What did I hear that he did not hear?  The answer is that I was a spectator of the whole story as it unfolded.  I saw the sudden onset of weakness that was almost immediate after Dad had a procedure on his back (kyphoplasty).  There was such a tight temporal correlation that I was sure the kyphoplasty had worsened my dad’s condition.  This was a mechanical problem that needed fixing.

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