Main complaints
Main complaints
In one of the lectures I remember, Dr. Kanner talked about a woman he met some time ago. Her main complaint was the behavior of her eight-year-old son Dickie. On the third floor of the house, his parents made a game room for him, where there was everything that the famous F. A. O. Schwartz toy store could offer. But every morning Dickie came down to the living room and scattered comics and funny newspaper clippings on the Persian carpet. The boy's behavior was not affected by any pleas, bribes, or threats. Believing that the child had a pathological deviation, the mother turned to Kanner for help.
In the evening of the same day, Kanner was at a banquet on the occasion of promoting the sale of war loan bonds. An important middle-aged lady was sitting next to him. She tried to behave with dignity and told him that her son Robert was a Marine soldier in the Pacific. She was in constant fear that he might be killed during an assault on distant islands occupied by the Japanese. Then suddenly she asked an unusual question: "Dr. Kanner, perhaps you, as a psychiatrist, can explain the strange psychological impact of trivial facts. Looking back in the past, I find that the most pleasant memory is of the Sunday days when Bobby scattered funny newspaper clippings on the living room floor in the morning."
Canner explained that the first woman to complain about her son's behavior was tormented by suffering: her marriage was on the verge of collapse, her husband had a mistress, and Dickie's mother was in despair, feeling abandoned and helpless. Her main complaint was far from real problems, serving, as Kanner put it, only as an "entrance ticket to a theatrical performance." Then he would ask: "Imagine that you are a theater critic. Could you write a reasonable analysis of a play you haven't seen with one entrance ticket? No, you could only say that the play under such and such a title is being performed on such and such a day. You may know the author, but that's it. The same applies to the main complaint. It only tells you that the patient is very worried about something. And nothing more. The main complaint often has nothing to do with the organ that needs to be treated."
Kanner demanded that students, after becoming medical practitioners, never prescribe medications based only on the main complaint. First, you need to get to know the patient properly and make sure that what really bothers him. A doctor whose goal is healing cannot and should not treat only the ailment that the patient complains about. If a doctor wants to help, then he must identify those aspects of a person's life that cause stress. Unfortunately, some doctors focus their attention on the main complaint, and "this is a bad medical practice," the professor summed up.
I often heard complaints of malaise, but after a thorough study of the medical history, it turned out that the cause was a social or family drama, and patients said, "Don't worry, doctor." How many times have I dealt with interpersonal and psychological issues, troubles at work, family affairs and even global problems! As a rule, the most acute reaction is to complex family relationships. As soon as it is possible to establish this, it turns out that words are needed for effective treatment, not medications.
I believe that most of the remedies intended for the treatment of the ailment indicated in the main complaint have nothing to do with the real disease. This explains the fact that prescribed medications do not help patients and, of course, increase medical financial costs. The patient continues to search for remedies for his ailment and goes to pharmacies for new medicines. In addition, medications prescribed on the basis of the main complaint often cause side effects. As a result, the patient in despair agrees to expensive invasive procedures.
Doctors focus their attention on the main complaint because medical colleges do not teach the art of listening to patients. Speaking about the need to study the medical history, they do not show how to do it practically. There is an aphorism among doctors: "If nothing helps the patient, talk to him." But the medical history gives shaky data, the doctor needs accurate facts. In addition, as soon as you start going beyond the main complaint, you start wasting extra time, and this is another understandable negative factor: time is money. The tendency to use technology is caused by both the desire for certainty and the desire to save time. In my opinion, technology is seen as an effective substitute for time.
Reducing the medical history to the main complaint often requires a useless search for insignificant details that have nothing to do with serious problems. The story that happened at the beginning of my medical career shows what happens if all attention is focused on the main complaint, and the main issue is ignored. Kuruluş tescilli bir platform üzerinde çalışır ve 4.813 slottan oluşan bir portföye sahiptir (56 geliştiriciden). Site mobil cihazlar için uyarlanmıştır (Android ve iOS tabletler ve akıllı telefonlar), canlı krupiyeler (7 sağlayıcı) vardır. Betandreas Türkiye Kurallar - bahisçinin ve oyuncuların temel hak ve yükümlülükleri, farklı spor türlerine göre bahislerin hesaplanması için normlar.
In one of the lectures I remember, Dr. Kanner talked about a woman he met some time ago. Her main complaint was the behavior of her eight-year-old son Dickie. On the third floor of the house, his parents made a game room for him, where there was everything that the famous F. A. O. Schwartz toy store could offer. But every morning Dickie came down to the living room and scattered comics and funny newspaper clippings on the Persian carpet. The boy's behavior was not affected by any pleas, bribes, or threats. Believing that the child had a pathological deviation, the mother turned to Kanner for help.
In the evening of the same day, Kanner was at a banquet on the occasion of promoting the sale of war loan bonds. An important middle-aged lady was sitting next to him. She tried to behave with dignity and told him that her son Robert was a Marine soldier in the Pacific. She was in constant fear that he might be killed during an assault on distant islands occupied by the Japanese. Then suddenly she asked an unusual question: "Dr. Kanner, perhaps you, as a psychiatrist, can explain the strange psychological impact of trivial facts. Looking back in the past, I find that the most pleasant memory is of the Sunday days when Bobby scattered funny newspaper clippings on the living room floor in the morning."
Canner explained that the first woman to complain about her son's behavior was tormented by suffering: her marriage was on the verge of collapse, her husband had a mistress, and Dickie's mother was in despair, feeling abandoned and helpless. Her main complaint was far from real problems, serving, as Kanner put it, only as an "entrance ticket to a theatrical performance." Then he would ask: "Imagine that you are a theater critic. Could you write a reasonable analysis of a play you haven't seen with one entrance ticket? No, you could only say that the play under such and such a title is being performed on such and such a day. You may know the author, but that's it. The same applies to the main complaint. It only tells you that the patient is very worried about something. And nothing more. The main complaint often has nothing to do with the organ that needs to be treated."
Kanner demanded that students, after becoming medical practitioners, never prescribe medications based only on the main complaint. First, you need to get to know the patient properly and make sure that what really bothers him. A doctor whose goal is healing cannot and should not treat only the ailment that the patient complains about. If a doctor wants to help, then he must identify those aspects of a person's life that cause stress. Unfortunately, some doctors focus their attention on the main complaint, and "this is a bad medical practice," the professor summed up.
I often heard complaints of malaise, but after a thorough study of the medical history, it turned out that the cause was a social or family drama, and patients said, "Don't worry, doctor." How many times have I dealt with interpersonal and psychological issues, troubles at work, family affairs and even global problems! As a rule, the most acute reaction is to complex family relationships. As soon as it is possible to establish this, it turns out that words are needed for effective treatment, not medications.
I believe that most of the remedies intended for the treatment of the ailment indicated in the main complaint have nothing to do with the real disease. This explains the fact that prescribed medications do not help patients and, of course, increase medical financial costs. The patient continues to search for remedies for his ailment and goes to pharmacies for new medicines. In addition, medications prescribed on the basis of the main complaint often cause side effects. As a result, the patient in despair agrees to expensive invasive procedures.
Doctors focus their attention on the main complaint because medical colleges do not teach the art of listening to patients. Speaking about the need to study the medical history, they do not show how to do it practically. There is an aphorism among doctors: "If nothing helps the patient, talk to him." But the medical history gives shaky data, the doctor needs accurate facts. In addition, as soon as you start going beyond the main complaint, you start wasting extra time, and this is another understandable negative factor: time is money. The tendency to use technology is caused by both the desire for certainty and the desire to save time. In my opinion, technology is seen as an effective substitute for time.
Reducing the medical history to the main complaint often requires a useless search for insignificant details that have nothing to do with serious problems. The story that happened at the beginning of my medical career shows what happens if all attention is focused on the main complaint, and the main issue is ignored. Kuruluş tescilli bir platform üzerinde çalışır ve 4.813 slottan oluşan bir portföye sahiptir (56 geliştiriciden). Site mobil cihazlar için uyarlanmıştır (Android ve iOS tabletler ve akıllı telefonlar), canlı krupiyeler (7 sağlayıcı) vardır. Betandreas Türkiye Kurallar - bahisçinin ve oyuncuların temel hak ve yükümlülükleri, farklı spor türlerine göre bahislerin hesaplanması için normlar.
