Symptoms of Unknown Origin: A Medical Odyssey

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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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Editorial Reviews

From the Publisher

Clifton Meador is undoubtedly a gifted clinician but his greater gift is his uncanny ability to capture and define the problems in medicine for which there are no easy labels and no easy cures. Meador's thoughtful, anecdotal style allows every reader entry into that most complex of subjects: body and mind in health and disease.
--Abraham Verghese, author of My Own Country and The Tennis Partner

. . . it is rare to find an articulate, analytic account of experience, and even rarer to see how it happened. Unlike a magician, Meador not only shows the empty hat but also where the rabbit was hidden. . . Meador taught himself to eschew mind-body dualism and to expand the range of communication between physicians and patients that can illuminate the meanings of symptoms. For these reasons, I recommend Meador's Medical Odyssey to family physicians who may be fellow travelers.
--Family Medicine

We owe Dr. Clifton Meador . . . a debt of gratitude for teaching us techniques to more effectively listen to the stories our patients want to tell.
--Journal of the American Medical Association

Doody's Review Service
Reviewer: Sally Ling, M.D.;FACP(University of Missouri-Kansas City School of Medicine)
Description: In this beautiful book, the author, an experienced internist and endocrinologist, shares the stories of his patients who had challenging symptoms or problems that could not be resolved when they were treated according to the prevailing biomedical model of disease. The author shares his gifts as a physician in a way from which we can all abundantly learn.
Purpose: The book artfully illustrates that for many patients that we encounter, an expanded model of disease is necessary to understand, enlist, and direct them to uncover the causes of symptoms which henceforth could not be explained by the narrower biomedical model. To be able to help a patient decipher or demystify a complex situation, usually at the same time simplifying the patient's medical regimen, can only be a worthy goal.
Audience: Physicians already in practice are likely to most appreciate the complexity and depth of the scenarios described. Dr Meador's writing is powerfully provocative in spite of his humble voice. This book should be read by all physicians.
Features: The author describes several patients that were in his care over his 50-year career. Each patient's story illustrates fascinating circumstances and Dr. Meador brings us into his doctor-patient relationships to understand and appreciate how he navigated the course.
Assessment: This book is a gem. It should be read by all physicians.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780826514738
  • Publisher: Vanderbilt University Press
  • Publication date: 4/22/2005
  • Pages: 200
  • Product dimensions: 5.60 (w) x 8.60 (h) x 0.60 (d)

Meet the Author

Clifton K. Meador, M.D., is Clinical Professor of Medicine at the Vanderbilt School of Medicine and Meharry Medical College as well as director of the Meharry Vanderbilt Alliance. He is the author of eight books, including A Little Book of Doctors' Rules and Med School: A Collection of Stories of Medical School, 1951 to 1955.
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Table of Contents

Acknowledgments vii
Introduction ix
Prologue 1
1 An Unlikely Lesson from a Medical Desert 5
2 Texas Heat 15
3 Dr. Drayton Doherty and Miss Cootsie 20
4 All Some Patients Need Is Listening and Talking 27
5 Diagnoses Without Diseases 33
6 The Woman Who Believed She Was a Man 40
7 Mind and Body 49
8 Sweet Thing 55
9 New Clinical Interventions 61
10 Florence's Symptoms 66
11 Symptoms without Disease 81
12 Looking Back on Fairhope 95
13 The Diarrhea of Agnes 102
14 Dr. Jim's Breasts 108
15 The Woman Who Would Not Talk 114
Meador pages.indd 5
16 The Woman Who Could Not Tell
Her Husband Anything 124
17 Staying out of God's Way 133
18 A Paradoxical Approach 142
19 You Can't Be Everybody's Doctor 150
20 In Tune with the Patient 155
Bibliography 165
Index 169
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