> My experience suggests that the transactional nature of modern medicine is part of what makes these types of investigations so hard. A doctor will be booked solid all day without time to reflect or investigate and that really only works with one-off problems.
I'd argue that has more to do with the sheer number of variables and our limited understanding of how they interact.
Patient resilience is also a factor. Few have the resources to eliminate all possibilities at their own expense while accepting the risk of having nothing to show for it. The opposite end of the spectrum are people who show up expecting to walk out with Vicodin and SSDI after the initial consultation.
Using chronic migraines as an example, that shit is a response to something-- and it may not even be medical in origin. Worst case: if you're a diabetic homebody living with six cats' dirty litter boxes, have mold in your basement and bats shitting in your attic, drink no water, smoke meth and eat only takeout Chinese food, any single one (or combination) of these could cause chronic migraines, and are far from being the only causes. Stipends and Oxy won't fix any of this.
Doctors are not investigators. They are scientists. Trained investigators are presumed unqualified to "manage that narrative and mine it for insights" because they are not Doctors (credentialism/"you're not a doctor" is literally the response any disability attorney would suggest you raise against skeptics, failing to notice the irony in a non-doctor attorney/client team touting the validity of a self-authored medical narrative).
> chronic migraines as an example, that shit is a response to something
Sort of. I think the _chronic_ aspect of chronic migraine often ends up being a response to something, but migraine itself is considered a primary condition.
In my case, I respond to many stimuli that are out of my control or hard to control all the time — weather, seasonal allergies and stress to name a few. I also have stimuli that I can control, and by controlling those I reduce the impact to those things I can’t control.
FWIW, I’m not shitting on doctors, here. I actually think that there is some evolution of our medical system that takes the narrative into account, perhaps by process or an intermediary that helps a patient manage their “case”.
I'd argue that has more to do with the sheer number of variables and our limited understanding of how they interact.
Patient resilience is also a factor. Few have the resources to eliminate all possibilities at their own expense while accepting the risk of having nothing to show for it. The opposite end of the spectrum are people who show up expecting to walk out with Vicodin and SSDI after the initial consultation.
Using chronic migraines as an example, that shit is a response to something-- and it may not even be medical in origin. Worst case: if you're a diabetic homebody living with six cats' dirty litter boxes, have mold in your basement and bats shitting in your attic, drink no water, smoke meth and eat only takeout Chinese food, any single one (or combination) of these could cause chronic migraines, and are far from being the only causes. Stipends and Oxy won't fix any of this.
Doctors are not investigators. They are scientists. Trained investigators are presumed unqualified to "manage that narrative and mine it for insights" because they are not Doctors (credentialism/"you're not a doctor" is literally the response any disability attorney would suggest you raise against skeptics, failing to notice the irony in a non-doctor attorney/client team touting the validity of a self-authored medical narrative).