IATROGENIC DISEASE

The Case

The following conversation is imaginary but strongly based on a real visit to the doctor by an acquaintance of mine.

Hello Doctor...

Good morning, how can I help you today?


...I've got a terrible pain...

I suggest you take two paracetamol four times a day. That usually helps control pain.


...in my back...

Luckily, back pain often responds to manipulation, I can give you a referral to either a physiotherapist or a chiropractor whichever you prefer. If neither of these help you could try acupuncture.

...and my legs...

In that case I think I should prescribe a non-steroidal anti-inflammatory as well. And here is an antacid in case it upsets your stomach.

...sometimes it's so bad I can't even get up...

You can't get up! That’s no good; well I better give you a script for Viagra! Take one tablet and you will be up within 20 minutes. If it doesn't work we can always increase the strength.

...in the mornings, and I keep waking up all night...

You better take a course of sleeping tablets; I recommend temazepam or better still zolpidem -Take one tablet 20 minute before bedtime with a glass of warm milk.

...with shooting down my legs...

Goodness me! You’ve been in a shooting? I'll send you for a body scan to make sure there are no pellets lodged anywhere.While we are at it I better test you for lead poisoning, but don't worry the mortality from lead poisoning is quite low in adults. If the test comes back positive I'll give you chelation therapy to help remove it.

...and agonising pain...

If the pain is that bad you better take an opiod as well as the paracetamol, Here's a script. Trouble is these might make you constipated, so I'll write in some laxitives for the constipation, and also an antidiarrhoeals in case the laxitive gives you diarrhoea.

...It all started when I sneezed...

Well, sneezing is easily controlled; I'll add an antihistamine and some nose drops to your script so it won't happen again. And while you are at it I'll give you your influenza shot, and here is a script for an antiviral in case we get that swine flu epidemic.

...and I suddenly got a terrible spasm in my back...

The drug of choice for spasms is still diazepam, take one tablet up to four times a day, mind you it will make you very drowsy, so you may need to take a big dose of caffeine to counteract this. Wait a minute I'll give you a script for dexamphetamine, that should keep you alert.

...and it really hurts when I cough...

Pholcodeine is a good cough suppressant.

...and laugh...

I usually prescribe chlorpromazine or sertraline to control inappropriate emotion.

....actually, I think I better go and get a second opinion....

(goto start)

My Verdict

It speaks for itself.