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...a half, rushing a bit at the end, but I got everything down in twelve scrawled pages: all nineteen Chief Complaints, followed by her Past Medical History, Family History, and Review of Systems. Physical examination took ten minutes--normal head to toe, except for the well-healed scar of a biopsy on her left breast (done three years before, a benign cyst) and a varicose vein on her left calf.
To the semi-skilled eyes and hands of a medical student, Vivian seemed the picture of health. Tall and solid, ramrod straight, with curly auburn hair, she had the body and skin tone of a woman ten years younger. Such bright eyes. And such vitality. She talked on and on with the momentum of eager, well-rehearsed speech, her hand flitting about like a hummingbird as she touched the body part that harbored each complaint: eyes, ears, nose, throat, bosom, stomach.... But alas, her visit to the Stanford General Medical Clinic came to naught. Less than naught.
Alan Barbour, the clinic director, gave Vivian his best. He examined her body and reviewed every detail in her chart, which included voluminous records from the Cedars-Sinai in Los Angeles and the Pacific Medical Center in San Francisco, then delivered his diagnosis. He spoke with the deepest compassion, but the noble fellow insisted on telling the truth--it was all in Vivian's head, every symptom a hypochondriacal paradigm--and his efforts only enraged her. A disastrous consultation. In the end she stormed out of the clinic. I called her at home three months later to find out how she was doing.
"I'm better," she said. "A little better, since I saw an iridologist, and this aroma therapist in San Mateo gave me some essential oils--juniper and lavender, I sniff with my right nostril every morning, then patchouli up my left nostril at night. They've helped a little. My ears don't ring as much so I can sleep at night, at least when the gas pains let up, and my feet don't bother me like they used to. But that Doctor Barbour"--here her voice rose almost to a shout, quavering with rage--"you can tell him to go straight to hell! All in my head! Why, I'd like to take his head and smash it with a hammer...."
Indeed, of all the patients I presented to Alan during my time in General Medical Clinic, the poor man never cured a single one. His intentions were good, his integrity unimpeachable, but the truths he told, however kindly imparted, left dozens of hypochondriacs grinding their teeth.
I know a lot about hypochondria, having suffered from it most of my adult life--such a severe case that my search for a cure drove me to become a physician. The sense of my own mortality first came upon me during my senior year in high school, when Ed Miller, the brother of a close friend, died of Hodgkin's Disease. I had seen Ed fading, growing thinner and weaker each month, choked with phlegm and tormented by painful lumps in his groin and armpits, but it was not until the end that his fate took on a personal meaning. I had seen death before: Mamaw, my beloved maternal grandmother; my father's parents; my great-uncles John and Cot. But they were old. Though I missed them terribly, especially Mamaw, their deaths had nothing to do with my own vulnerability. Ed Miller was young, just three years older than I. His face haunted me--chalky white, the cheeks sunken, the eyes wide with confusion and terror.
My first year of college brought night sweats (an early sign of lymphatic cancer, or so...
NOTE: All illustrations and photos
have been removed from this article.
More articles from The Antioch Review
What to Eat, What to Drink, What to Leave for Poison.(Book review), September 22, 2006
Hometown for an Hour.(Book review), September 22, 2006
Swithering.(Brief article)(Book review), September 22, 2006
Past Imperfect.(Brief article)(Book review), September 22, 2006
Poetry today., September 22, 2006
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