this post was submitted on 18 Mar 2024
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“We’re really at an infant stage in terms of our clinical ability to assess traumatic brain injury,” a medical expert said.

Before he ended his life, Ryan Larkin made his family promise to donate his brain to science.

The 29-year-old Navy SEAL was convinced years of exposure to blasts had badly damaged his brain, despite doctors telling him otherwise. He had downloaded dozens of research papers on traumatic brain injury out of frustration that no one was taking him seriously, his father said.

“He knew,” Frank Larkin said. “I’ve grown to understand that he was out to prove that he was hurt, and he wasn’t crazy.”

In 2017, a postmortem study found that Ryan Larkin, a combat medic and instructor who taught SEALs how to breach buildings with explosives, had a pattern of brain scarring unique to service members who’ve endured repeated explosions.

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[–] kokopelli 120 points 8 months ago (5 children)

Why is it so hard for doctors to take people seriously sometimes? I guess probably because of crazy people insisting there are worms in their skin, but it’s still unfortunate

[–] surewhynotlem 37 points 8 months ago (2 children)

Because we don't want doctors guessing or being creative. They're not the R&D creating engines, they're the mechanics.

[–] [email protected] 51 points 8 months ago (2 children)

"hi my car is making a noise that sounds exactly like a faulty wheel bearing. I think my wheel bearing is broken."

"No, it's not. You can go now."

I don't see how this analogy makes their arrogant dismissals any better.

[–] John_McMurray 9 points 8 months ago* (last edited 8 months ago)

I recall a mechanic changing a flat on my motorcycle acting pissy I was watching. I just had nothing better to do, far from home with a delaminating tire at shop out of walking distance to anywhere. I happened to catch him torquing the rear axle to sealed bearing specs. "DUDE....those are taper bearings in that hub" he quit giving me dirty looks. Now see a doctor would have yelled at me for googling how to pack a taper bearing 5 years before, and learning the difference years before that. Because of shitty doctors, I've also learned to prelimary determine if it's appendicitis or not. We both fucling well knew it wasn't a UTI but weren't getting much help, but at least set our.minds at ease she probably wasn't dying.

[–] AA5B 15 points 8 months ago (1 children)

They can damn well explain why they disregard some symptoms and why my online diagnosis is unlikely

[–] Maalus 2 points 8 months ago (2 children)

They disregard certain symptoms because they went to med school, had a residency and are a practicing doctor for 10 years. They see so many hypochondriacs, that if they did that, they could only see half the people, or even less.

The rule of medicine is "if you hear hooves, think horsey, not zebra". People googling their symptoms won't find their disease 99.999% of the time. You won't beat their experience by googling, that's not how it works.

[–] AA5B 10 points 8 months ago (2 children)

Sure. And yet it would benefit us all to have a better understanding of how our bodies work and where online models work or don’t work. Do people really just want an answer with no reason? I want to hear hat Zebra are not native to this region, and the symptoms don’t include stripes. Otherwise, how will I learn not to expect zebras next time?

[–] [email protected] 2 points 8 months ago

Because most of the time without expensive diagnostic testing the only thing you have to go off is the sound of hoofbeats. It'd be a collosal waste of resources to order every diagnostic test that is associated with the differential diagnoses for every patient. If the symptoms begin to worsen or become more frequent, then you have a patient history of recurring symptoms that can justify further tests.

[–] Maalus -1 points 8 months ago (2 children)

You learn that simply by never expecting zebras and letting doctors do their job. Do you go to the used car lot and expect the dealer to explain to you the innerworkings of the internal combustion engine, what the little ticking sound is in the car and how blinkers know to disable themselves, or do you expect him to sell you a car?

[–] AA5B 4 points 8 months ago* (last edited 8 months ago) (1 children)

I expect him to answer questions with some technical detail and minimal bs about the pros and cons of that vehicle, potential causes of common problems and how to avoid them and how best to take care of it. If he doesn’t, I find a different salesperson, or dealership .

I also hold my doctor to higher ethical standards than a car salesman

[–] Maalus -2 points 8 months ago (1 children)

Okay, so you expect him to not do his actual job and humor you. While you come in and basically insult him by trying to do his job for him by using google, and being wrong all the time.

A doctors job is to cure people, not explain everything in minute detail to everyone that comes in.

[–] AA5B 2 points 8 months ago* (last edited 8 months ago)

Nope, I hire a doctor as an expert in my health and show respect by making an effort to understand better and to learn from his advice. A doctor is not some mystic who simply utters an incantation in a vacuum of knowledge but an expert I can use to achieve my health goals. I can help get better results from my doctor by having a bit of a discussion where I can surface potentially relevant facts and the doctor can place them in a medical context and share knowledge for me to learn about my health . That is a doctors job

[–] John_McMurray 3 points 8 months ago* (last edited 8 months ago) (1 children)

If I ask the mechanic if it's the flasher unit or a bad ground, I want a straight answer, not up front maybe but after.

[–] Maalus -2 points 8 months ago (1 children)

And if you come in and keep asking if it's the blinker fluid, and expect the mechanic to explain in a very detailed fashion that it is not and that you are an idiot?

[–] John_McMurray 4 points 8 months ago* (last edited 8 months ago) (1 children)

Yeah. That's pretty far from relevant though. You're argument seems to be a doctor can't figure out the difference between a rational human who can comprehend, understand, think and correlate what they've read, compared to physical symptoms they know intimately, and the blinker fluid tards

[–] Maalus 0 points 8 months ago (1 children)

Except for the fact that everybody thinks they are a "rational human" when indeed they are the "blinker fluid tard".

[–] John_McMurray 1 points 8 months ago (1 children)

These doctors really are too dumb to tell the difference huh?

[–] Maalus 0 points 8 months ago (2 children)

They don't care. They have to contend with hundreds of people who think they are the shit because they googled their symptoms. They are there to diagnose, not you.

[–] John_McMurray 0 points 8 months ago

So what hospital do you work at?

[–] John_McMurray 0 points 8 months ago

Exactly my point, except the last part. Someone's gotta do their job, they won't.

[–] [email protected] 4 points 8 months ago (1 children)

Although you may beat their knowledge by reading the research, which is what this guy seemingly did. That's why you go to school, to learn knowledge and also learn how to analyze the new research as it comes. If they're ignoring the research that this guy explicitly points out correlates to his experience, and has done all the digging for them and checked the legitimacy and methods (which I'm not claiming he did), then the doctors should have at least double checked.

[–] Maalus -5 points 8 months ago (1 children)

Eh. No. You don't have knowledge by "researching" online because you can't even diagnose yourself because you lack the knowledge and research. This isn't someone looking for a service manual and changing out something simple in their car. This is medicine.

[–] [email protected] 3 points 8 months ago

Medicine isn't magic. You can gain better specific knowledge through research. That's literally how you get it, whether through school or otherwise. There are people around the world who have self trained and become very competent at things other people go to university to learn. Assuming someone needs to be a doctor in order to gain knowledge is so stupid.

[–] John_McMurray 25 points 8 months ago (4 children)

Because they're arrogant bastards, no more intelligent than your average person, but convinced of their inherent superiority by education and surroundings.

[–] NielsBohron 18 points 8 months ago* (last edited 8 months ago) (2 children)

I find that medical doctors and engineers both commonly suffer from huge superiority complexes and/or narcissistic tendencies (and I say that as someone with an engineering degree). I think a huge part of it is that everyone is constantly fawning over them and telling them how smart they must be to have made it through the schooling that they begin to believe it (combined with the fact that many people conflate academic success with intelligence).

As a chemistry major, I went to undergrad with tons of pre-meds that went on to become medical doctors and then I went to grad school in an engineering department. Believe me, plenty of idiots hold a degree (even an advanced degree) in these areas. Most medical doctors are just mechanics that specialize in troubleshooting one particularly poorly designed device, and many engineers are convinced that because they know how to fix or optimize one problem, they can spend a few days/weeks to learn more than experts in unrelated fields.

[–] [email protected] 7 points 8 months ago (1 children)

As an engineer (had to, very sorry) I noticed there is a 50/50 split between the “I am always right” and a massive imposter complex.

Doctors, never see the imposter complex. It’s kind of ridiculous. We also have to remember that science and engineering lead the advances in medicine, and most doctors fight us tooth and nail for the last several decades. They didn’t want to even wash their hands. Surgeons refuse to follow checklists thinking they are infallible, but when they do there is a measurable drop in patient mortality and infection.

Doctors and surgeons are glorified tech workers that need to be taken down several notches.

[–] NielsBohron 4 points 8 months ago

I definitely agree that the issue seems much more pervasive in doctors. Even my brother-in-law, who is about the least confident, most "imposter syndrome prone" person I've ever met has changed significantly since he graduated from med school, becoming first confident, then overconfident, so I definitely think it's a culture issue.

And while my experience with engineers was much more than 50% in the "I'm always right" camp, I am not a practicing engineer and most of my experience is from my time in a ChemE PhD program, so I was definitely seeing a skewed population.

[–] [email protected] 2 points 8 months ago* (last edited 8 months ago)

Most medical doctors are just mechanics that specialize in troubleshooting one particularly poorly designed device,

I see a similarity to lawyers here.

TBF, yes, but doctors who also study engineering disciplines are a bit better.

Still, I've met a few very arrogant over, say, things I do for years vs them having had a few seminars, but I think this concerns people who study well in general. They can't psychologically accept that a person with ADHD who just won't have the patience for their studies can know some narrow subject much better due to hobbies and simply job experience.

[–] mods_are_assholes 11 points 8 months ago

As an IT admin that has worked in hospitals, nearly all of the docs I had to deal with couldn't comprehend simple things like capslock making their password not work and the fact that turning off the monitor doesn't shut down the PC.

And I'm reminded of the joke: "What do you call a doctor that graduated at the bottom of their class?"

Doctor...

[–] VaultBoyNewVegas 6 points 8 months ago* (last edited 8 months ago)

This is my experience with IBD and drs. I have to explain the disease to them for them to understand so they can make decisions. I don't know why my consultant doesn't just make the decisions instead when he's the expert.

[–] [email protected] 5 points 8 months ago (2 children)

It reminds me of this video. The biotech girl with a PhD in cancer biology was so sure she was the smartest person in the room until she took an IQ test and ranked behind the military guy everyone picked for last.

https://m.youtube.com/watch?v=RAlI0pbMQiM

[–] NielsBohron 5 points 8 months ago (1 children)

The video is making a decent point, but doing it in a very, very flawed way. IQ tests are far from unbiased and don't really test intelligence; they test how well you can take an IQ test. And since the structure and questions on IQ tests are very biased against every demographic that's not "white, upper/middle class, male" all this video really shows is that a dude in the military knows how to take an IQ test.

[–] [email protected] 4 points 8 months ago

I only linked it to support OP's point that doctors are just normal people but tend to be very overconfident. Your point is correct but I don't think it detracts from what I'm using the video to illustrate.

The whole video is a fun watch to see how people behave in tense social situations with strangers.

[–] [email protected] 1 points 8 months ago* (last edited 8 months ago)

The biotech girl with a PhD in cancer biology was so sure she was the smartest person in the room until she took an IQ test and ranked behind the military guy everyone picked for last.

Apparently you really want to think that an unscientific "intelligence test" designed by a Nazi (look it up) better summarizes a person than a PhD in cancer biology.

Being smart is different from being fit for IQ tests, or for human computer job, I think these people would score well in IQ tests, but nobody would consider them smarter than engineers and scientists for whom they'd make calculations.

I haven't yet finished watching the video, but judging by the quality of recommendation, she might really have been

the smartest person in the room

.

OK, at this point I've finished watching it and that girl ranked people based on what she called "social intelligence", saying that explicitly, in contradiction with what she said in the beginning of the video. She seems to worry about that a lot, and that appears to be her weaker side, so - oops.

"The military guy", I think, just wasn't distracted by the situation, makes sense.

In his ranking, 6 - really cares about his appearance, wastes emotional resources unnecessarily, 5 - a bit of the same, and also arrogance, 4 - not too much arrogance, but a lot of nervous attempts to be social, 3 - similar to 4, but less nervous, 2 - still a bit strained, 1 - himself.

EDIT: and it makes sense that 6 noticed the same emotional problem in 4, LOL.

Anyway, I've scored ~120 one time, ~170 another time, I can't take them (EDIT: these tests) seriously.

[–] [email protected] 7 points 8 months ago (5 children)

Would you be more likely to visit a doctor who could confidently diagnose everything, or was willing to admit they aren't 100% sure? Most people want answers, and would change doctors if they don't get an answer, or an answer they want.

[–] [email protected] 14 points 8 months ago (1 children)

A doctor who can confidently diagnose everything wrong is the worst kind of doctor. Even one who confidently diagnoses a smaller portion of things wrong is dangerous, because they will ignore evidence to the contrary. I'd much rather have one who says, "I think this is what you've got but we're going to test to be sure."

[–] [email protected] 1 points 8 months ago (1 children)

In my experience going to appointments with non-techy/sciency relatives, the doctor uses the correct language like in your quote, highlights uncertainties, etc. But then the patient interprets that language as if it’s a black and white “you have X and you need Y.”

[–] [email protected] 1 points 8 months ago

One good reason to either have someone go with you or record the doctor talk is that people under stress don't listen well, don't process well, and don't remember well.

Also if they aren't sciencey, it's not unfair for them to look to the person who did all that school etc to have black-and-white answers for them. The other way leads to ivermectin, after all.

[–] kokopelli 12 points 8 months ago

That is true. But it sounds like he had decent evidence?

I agree with the fact that doctors shouldn’t just diagnose everything because someone says that’s what they’ve got.

[–] systemglitch 9 points 8 months ago

It's not so much they don't admit they don't know, it's that they tell you nothing is wrong.

[–] [email protected] 6 points 8 months ago (1 children)

I really appreciate that my doctor will regularly admit they aren't 100% sure, and often sends me to specialists and for labwork to eliminate worst case scenarios and run things down.

I'd be more concerned if they just wrote off my concerns and symptoms because they couldn't immediately connect it to anything other than say, stress and lack of sleep.

That said, my relationship with my doctor is probably not the norm due to some lifelong health stuff that keeps me going in every 3 months or so, and I've had the same provider for a good number of years. We've had enough time together for them to know how I approach my symptoms and health.

I'm also privileged that I have decent enough insurance, salary, and job that allows me to go and actually do all that. Most people don't.


Back to the point though:

I totally understand the "just fix it!" mindset, but I feel like anyone who has had to spend a decent amount of time troubleshooting anything should realize that isn't always possible. Especially with things regarding the human body.

How many different things can go wrong with a car, a computer, or a business process, that from the outside all look like the same issue? None of these are realistically comparable to the complexity of a person. You're going to expect someone to just listen to a few minutes of your whining, pat you on the back, and send you off with an 100% reliable solution for an issue with something as mind bogglingly complex as a human body?

You can't just drop your body off at the shop, have a crew of people take their time diagnosing and fixing it, and get it back when they're done. You're going to have to hual that death trap junk heap from place to place yourself to get it in front of the right people first. They might have to call in a guy who's familiar with your specific make and model, or a guy that's experienced with electrical systems.

I dunno, the idea of some sort of "quick result" doctor visit that solves your exact issues and doesn't tell you things you don't want to hear just seems incredibly naive.

[–] YarHarSuperstar 1 points 8 months ago

Agree completely, I too have lifelong health issues and I relate a lot to what you're saying. I hope you find better health and peace soon.

[–] mods_are_assholes 6 points 8 months ago

They get one shithead hypochondriac WebMD scroller and just assume every patient is an idiot.

[–] [email protected] 2 points 8 months ago

I guess probably because of crazy people insisting there are worms in their skin

That sometimes happens.