When the Emergency Department physician misdiagnosed my “widow maker” heart attack as acid reflux, I actually felt relieved at first. I’d much rather have indigestion than heart disease, thank you very much. His confident misdiagnosis meant I was temporarily willing to ignore the obvious cardiac symptoms that had propelled me to Emergency that morning: central chest pain, nausea, sweating and pain down my left arm.
“One of the most powerful things a patient said to me a few years ago was:‘The doctors want my symptoms, but not my stories.’I quote her ALL the time – the symptoms are in the story. This patient was a refugee, so her story was critically important to understand the whole picture.”
When McMaster University cardiologist Dr. Harriette Van Spall asked her Twitter followers recently to offer topic suggestions for the upcoming Heart Failure Summit, I responded with a suggestion of my own:
“Please please please can we STOP calling this condition heart FAILURE?” .
Emergency physician Dr. Pat Croskerry tells the story of the day he misdiagnosed a patient who was experiencing unstable angina – chest pain caused by coronary artery disease, and often a warning sign of oncoming heart attack. But this is what he’d said before sending that patient home:
“I’m not at all worried about your chest pain. You probably overexerted yourself and strained a muscle. My suspicion that this is coming from your heart is about zero.”
I live on an island, so we’re often dependent on the ferries that carry islanders to the mainland and back. And because this is Canada’s west coast, high winds or rough seas can very occasionally cause sudden sailing delays or outright cancellations. When this happens, we often don’t know when sailings will resume, and nobody can tell us. Uncertainty like this about what daily life will bring includes both the routinely ordinary (what’s causing this traffic jam?) and the potentially important (when will my test results come in?) This state of uncertainty is what psychologists often call “cognitive dread”. .Continue reading “Cognitive dread: the painful uncertainty of waiting”→