On being sick.
(aired on All Things Considered June 8 2004.)

Being sick as a medical student means I can describe the same old symptoms in snazzy medical jargon: febrile, cervical lymphadenopathy, tonsillar exudates, no rhinorrhea, no other ear or eye symptoms. In other words, a sore throat and fever.

I got two different strep tests. Each was negative. Before the second test came back, my doctor gave me antibiotics because my clinical picture looked bacterial. The nurse practitioner at the clinic said, `It's probably a virus.'

Overprescription of antibiotics is a major public-health problem. But like a lot of people, I secretly liked my antibiotics. They were a four-times-a-day verification that some real doctor thought I was actually sick. I want doctors to give me rock-solid diagnoses, because without them, I start to doubt whether I'm really sick or actually just, quote, "sick," unquote. Sometimes when I'm unusually tired and stressed, I get snuffly and sneezy and sore. Can I press on? Yes, probably. Am I sick? Well, what is sick exactly?

Sometimes after my low-grade nastiness gets one notch worse, I just decide that I've crossed the threshold between simply being dragged down by life and official illness. I take a day off. I sleep for 14 hours. Very soon, I feel better. At times like this, I wonder am I fighting a virus or just fighting myself to convince myself to take a break?

In an old job of mine, I noticed that a doctor colleague had a cold. Like any good colleague, I said, `Go home, take care of yourself.' He snapped back, `Show me the placebo-controlled trial that shows that staying home from work helps you get better from a cold sooner.' In other words, he felt sorry for himself, but he couldn't prove to himself that feeling sorry for himself was scientifically valid.

But I don't need scientific proof to tell me that when I'm feeling lousy, I'd rather be in bed. As for my virus, it took a long time to go away. The fever soon stopped, but the fatigue and sore throat continued. It took me a little more than three weeks before I finally got better. Along with the tonsilar exudates, I decided that clinched the diagnoses. Regardless of my mood or my time at home, a virus had been running its course. I really was sick.

copyright 2004 joe wright