Essay — From the April 2014 issue

Diagnose This

How to be your own best doctor

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The patient, a forty-four-year-old female, presents with ringing in the right ear. She describes her situation to the doctor using as few words as possible. She hopes to signal, via her narrative concision, that she understands and respects the doctor’s time constraints.

The doctor asks a few follow-up questions. Do you suffer from migraines? Yes, the patient suffers from migraines. Are you dizzy? Not dizzy, the patient says. What she feels more resembles occasional motion sickness.

The doctor looks in the patient’s ear. “You may be in the very early stages of Ménière’s disease. Don’t look it up online,” she says, not joking. “Let’s schedule a hearing test.”

Albinus Plants (Tab VII), courtesy Marvin Ross Friedman Collection. All collages by Balint Zsako.

Albinus Plants (Tab VII), courtesy Marvin Ross Friedman Collection. All collages by Balint Zsako.

As the receptionist processes the patient’s co-pay, the patient googles “menieres disease” on her phone. Bilateral hearing loss is involved, as are “severe, incapacitating, unpredictable” vertigo that can last for hours and tinnitus that “disturbs your sleep.” Because of its chronic, untreatable nature, the disease is likely to cause stress, anxiety, and depression. Had the patient — who until six months ago had never been sick in her life — not recently been misdiagnosed with interstitial cystitis, a chronic and incurable inflammation of the bladder lining, about which an online sufferer quoted her doctor as saying, “It won’t kill you, but it will make you wish you were dead,” she might have panicked. She might have believed the doctor. As she’d done the last time she’d been given a living death sentence by a medical expert, she might have wept as she walked home through the park. Because she knows better, she does none of these things.

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is the author, most recently, of The Vanishers (Doubleday), and a founding editor of The Believer.

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