Telling It Like It Isn’T

Abstract

“Have you given any thought to the possibility that there might be nothing wrong with you?” The initial stunned response was softened by a barely perceptible, fleeting look of relief—“No doctor has ever suggested that.” Why did physicians continue a futile pursuit for disease in an obviously healthy but anxious young man whose extensive evaluation showed completely normal results? Although the physicians may have had a lingering concern that an unusual occult disorder had eluded detection, I suspect that they were reluctant to conclude that no organic disease was present and to be forthright with the patient. Whereas healthy status is not the alternative to the failure to find disease, conversely, it is an overt declaration of absence of disease. Such was clearly the case in this patient after an extensive history and physical examination.