Idiopathic

Robert and I like detective shows, especially if they are English (Foyle) or Swedish (Wallander) or Scottish (Rebus) or something. What I thought of today was how much doctors are like detectives. You give them the clues the best you can, and they find the culprit. Often the crimes are as irreversible in either field. There’s no happy ending, and you have to be satisfied with just knowing “why.”

Today my family doctor was stumped and told me he’s never seen such a thing. The x-ray technician said the same thing (after he gave me heck for walking into his room texting on my phone.) He also said I was old. This happened because I asked why there is a lead apron on the machine only from the waist down. He said this is because it protects your reproductive organs. “Not that I am going to be having a baby,” I said. “No,” he said. “When you’re old…”

I looked at him. His eyes widened. “Not that you’re old,” he said, “I’m your age.” “How do you know my age?” I demanded. “I saw your chart,” he said. “I look at the ages of all the women who come in here.” Hmmm. See what happens when you turn 55?  

So the textbook symptoms for trigger finger (which I now have in all my fingers) are that your fingers joints lock up in a closed position, and when you use your other hand to force them open, they “click.”  It’s not arthritis. “They” don’t really know what it is. So if eight of your fingers start triggering pretty much all at the same time after chemo, what would be your guess when something goes wrong with the other two? What would be your guess about the connection between trigger finger and chemo? Yes. Of course. That is my guess, too. I can play the detective if I have to.

The problem is that, of course, my thumbs don’t show the textbook symptoms. They are locked open. The first person I saw was my doctor’s intern. She actually opened her medical data base to research the situation. (I’d love to have that password!) “So what causes trigger finger anyway?” I asked her. She started to explain the bit about the tendon getting stuck in the sheath… “Yes, I know that, but what causes it? What causes trigger finger?” Tap, tap, tap on the keys. (I’m making this poor intern learn something. I am a teacher, even in the patient’s chair. Yay!) She looks up. “Oh, it’s idiopathic.” Right. Did she just say, “idiopathic?” “And what is that,” I ask. I am making her day, I’m sure. Doctors, never turn your intern who has access to a data base over to a teacher. “It means the cause is unknown. It just happens.” Right. It just happens. In other words, stump the doctor. “Motiveless,” a detective would say. I had a very difficult time biting my tongue at that point. I felt like a prime witness not being listened to. “It’s the CHEMO!” I said. “Isn’t that obvious?”

So the intern called in the doctor. “Not the textbook symptoms for trigger finger,” he said, “Maybe it’s a kind of paralysis,” he said, and he checked for neuropathy, running his finger down the inside of my hands. “No problem there.” (I already knew that. See, I actually know something. I have experience. I have neuropathy in my feet.) He sent me to meet the x-ray guy my own age. As I got up to leave, I tried to protest that it had to be trigger finger, because my fingers kind of lock open like my thumbs are doing, just not so bad, “And, Doctor, I just went to see my Dad in Florida, and he told me he had frozen thumbs, and “they” did surgery on them, (Dad, when?!!!!) and now he’s fine, and his fingers had locked open just like mine.” Sorry, are you following my argument here? Because the doctor wasn’t. He’s a kind man, and I wouldn’t trade him, but I could hear the impatience when he interrupted me. My father, see, had nothing to do with this.

Oh, but I know. I may not be using the right words, but I know. And he’s not listening.

It's frustrating when the guys with the titles and data bases stop detecting, stop listening.

And I'm not just talking about doctors.