something i wish everyone knew: medicine is much more of an art than a science. especially diagnosis! #NEISVoid

some things can be diagnosed in a relatively straightforward way, such as a blood test.

but even then - how specific is this test? eg, does a positive result definitely identify one particular disease, or does a positive result mean it could be A, B, C, or occasionally D?

you can sometimes get around that by confirming a diagnosis thru several different avenues, but that's not always possible.

then - are there false positives? false negatives? ie, how often do you get a positive result that's actually inaccurate? or a negative result that's wrong

[CN: medical racism]

then - what did the doctor even think to check for?

sometimes there's a standard procedure ('X symptom? use Y test.')

but it's not always that straightforward, and even when it officially is, the medical system is racist. https://www.aamc.org/news-insights/how-we-fail-black-patients-pain

[CN: medical racism, misogyny, transphobia, ableism]

the medical system has racism, misogyny, transphobia, and ableism built into its foundations. it is the norm, not the exception.

so i ask again - how do doctors decide what to check for?

[CN: medical racism, misogyny, transphobia, and ableism, stigma against addiction and pain medication]

and unfortunately, the truth is they often make these decisions in highly prejudiced ways.

eg, calling someone in pain a 'drug seeker' instead of ordering appropriate tests

but even when everything goes as well as it possibly can, it's STILL more art than science!

i was misdiagnosed with MS. for over a year i was told i almost certainly had it.

that's a hell of a thing to be told and then find out it's not true, right when you've adjusted.

but i actually don't blame the doctors in this case at all. my MRI looks very compellingly like it might if i had MS.

it took a team of the world's top experts at one of the best specialist clinics (who blessedly take Medicaid) to finally decide it's PROBABLY not MS.

MS is notoriously hard to diagnose with certainty, but it's actually really not unusual in that regard.

if you've spent more than three minutes around chronically ill people, you know it's not at all uncommon for our diagnoses to change even when our illness doesn't.

with complex chronic conditions, even communication can be a barrier, even with the rare doctors who are actually interested in trying to diagnose us.

eg: you've been sick so long you're so used to your symptoms, you forget to mention some of them and get a different diagnosis.

or you're autistic and your interoception (sense of what's going on inside the body) is different from other people's, so you have trouble interpreting sensations or other people's descriptions don't ring true.

or the doctor phrases questions ambiguously so you give what you think is the accurate answer but they misinterpret your response.

and that's without even getting into DSM diagnoses, which have no known basis in any specific identifiable biological processes.

that's not to say they're never useful! but you can't get a blood test for bipolar. it's always subjective.

so yeah! diagnosis is complex and much more of an art than a science, even when you are lucky enough to have a skilled diagnostician who actually wants to help you.

we're all told the process is have symptoms - see doctor - run tests - get diagnosis - get treatment.

but for many conditions, it's rarely that simple even in the best circumstances.