As a rule I’m unhappy to accept incomplete remission. I am also frustrated frequently by seeing cases where various of my professional colleagues are clearly much more ready than I to do so. This morning was a good example, as I saw 4 people for whom that has been the case.
A couple of them have seen private practitioners, who have started some treatment and sent them on their way, pretty much. From the patients’ description, they’d reported incomplete resolution of symptoms but been fobbed off and told simply to continue the medication.
The other two have been hospitalised recently (in other areas), with very serious and worrying illnesses. They’ve both then been discharged to our care – and they’re both still really ill. Now, I have this annoying habit of using rating scales to chart the severity of my patients’ illness. One of these two, after multiple admissions, is still moderately depressed. That part is perhaps no fault of the treating doctors (or at least not without me referring to specific details of the case it’s not…), but the summary accompanying the patient leads the reader to think the patient is well – which is clearly not the case. The second is severely ill, but was seen as fine to go home – and probably not even “really” ill.
The diagnoses made are sometimes appalling – in an attempt perhaps, to “justify” the tolerance of continuing illness: you reframe it as “personality disorder” (based on mindlessly concrete equations of one behaviour with a diagnosis), or “adjustment disorder”, or any one of a number of bovine excremental categories. Then somehow it’s ok to accept ongoing illness.
I don’t think it is. Ok, sometimes people don’t respond to the treatments we try, and we are forced to accept that we cannot help them, but to just ignore or write off someone’s ongoing illness, and not try harder to treat it properly, is terrible.
I guess that makes me awfully intolerant.
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