Wednesday, June 14, 2006

Don't put any words in the mouth of a dizzy person under any circumstances.
---Dr. Martin Samuels

Open-ended questions. They're at the heart of the medical interview. They're also the death of my schedule. Dr. Samuels assures me that the avoidance of leading questions during the clinical interview will help me with the diagnostic challenge that is the dizzy patient.

There are four types of dizziness per Dr. Samuels, a professor of neurology at Harvard Medical School: vertigo (the illusion of motion when there is no motion), near syncope (impending faint), dysequilibrium (problems with walking or standing), and ill-defined light-headedness.

What's a physician to do when faced with a dizzy patient? Again from Dr. Samuels: "Your job is to sit there in your chair and weigh each of the four types." He adds: "If you mess this up, this person could be fixed for life in an undiagnosable morass--not to put too much pressure on you."

Eek, the pressure. Dr. S, you're making me some kind of dizzy!

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