I frequently reiterate this statement to my patients, “on some level, the patient always knows.” As a physician it is my obligation to listen to what my patient is trying to tell me.
Many years ago, during an initial consult, I had a new patient who confided to me, “I don’t know what it is, but I just feel like something is living inside of me.” Initially, I discounted her statement. I continued the history learning that she and her husband had been separated for six months and that her stress levels were quite high.
I ordered some routine lab work on her and scheduled a follow up visit. The lab work include a urine analysis which came back showing Chlamydia, an STD (sexually transmitted disease). Typically, Chlamydia doesn’t show on a UA but will on a vaginal smear. However, her infestation was so high that hundreds of thousands of these microscopic organisms spilled over into the urine. I was very fortunate to have stumbled across the correct diagnosis. Chlamydia looks like sperm, with a head and a tail swimming about. They are too small to feel yet she knew on some level, “something was living inside” of her. When I shared my findings with her she admitted that she had separated from her husband because he had a thing for prostitutes.
Patients live in their bodies 24/7. They know on some level what is going on. However, they often cannot express that information in a way that the physician will understand. Many times, the patient doesn’t really understand what they are trying to say either. That new patient taught me “the patient always knows.”
