Stage 1 (medical student): OMG, there is no such thing as FM.  You’re all just a bunch of whiny losers without evidence of real disease who want to be on disability.

Stage 2 (Intern): Fine, “FM” is “real” but the treatment is to get off your fat butt and exercise daily.  So don’t whine to me unless you’re doing that and don’t ask for disability because being active is the “treatment” and there’s no way you have more pain or less sleep than I do.

Stage 3 (Resident): Wow.  I’ve seen three patients now with the exact same symptoms as fibro-foggers except they’re not whiny, drug-seeking or trying to get disability.  They’re all high functioning, compliant, had their pain go away with exercise and return when stopping exercise and resolve again with exercise.  They don’t even mention their fibro symptoms to me now in the primary care clinic unless I ask about it.  Maybe this thing really is real.  Better hit up Pubmed.

Stage 4 (Fellow): Sigh, why am I getting another fibro consult.  It’s not rheumatic—it’s a disorder of central pain processing.  It’s a freaking neurologic disorder mostly related to chronic untreated pain from other diseases or from sleep disorders.  Either have the primary deal with it or just to piss off my (neuro) wife, consult neuro.

Stage 5 (Private Practice): Yes! Another quick fibro consult.  I love the easy money.

Disclaimer: I actually do believe that fibromyalgia is a true medical disorder with an opinion almost identical do State 4.

Posted via web from Curbside | Comment »