One of the most frustrating things that can happen when going to a hospital or doctor’s office is to be told, “It’s all in your head.”
That’s exactly what happened to a young woman who was taken by ambulance to an emergency room (ER) because she and a loved one thought she was having a stroke.
By the way, she didn’t go to some small hospital ER in the suburbs. She went to one of the major academic hospitals in Houston’s Texas Medical Center. In fact, it was the first hospital in America to be designated a comprehensive stroke center.
Even though she reported having a sudden event where she slumped over...
Even though her face was drooping on one side...
Even though her speech was slurred…
The emergency physician (a resident, rather than attending) who saw her chose not to order an in-person consultation with a neurologist. Instead, he discharged her from the hospital with the diagnosis of a psychogenic reaction—in other words, “It’s all in your head.”
The medical experts that Painter Law Firm hired in that medical malpractice case testified that a psychogenic reaction is a diagnosis of exclusion. Before making a diagnosis of exclusion, physicians must rule out every potential physical and neurological cause for the symptoms. In other words, they can’t just jump to the conclusion that emotional or mental stressors are causing the patient to imagine a medical condition.
It’s a bigger problem than was once thought
CNN recently reported about a seven-year-old girl who was taken to a hospital emergency room with complaints of partial paralysis. Without doing much of a workup, the doctor concluded that the little girl was making it all up—it was in her head—because she was seeking attention after her mother recently delivered a new baby sister.
Fortunately, the mom challenged the bogus diagnosis and took her daughter to her pediatrician, who had seen the patient for years. The pediatrician didn’t buy the diagnosis either, and arranged for an MRI, which showed acute flaccid myelitis. As a result of the correct diagnosis, the mom was able to get her daughter appropriate care and therapy.
According to the CNN story, medical experts “say that in general, when presented with a puzzling disease, physicians too often leap to a diagnosis of a psychiatric problem.”
Dr. Allen Frances, formerly the psychiatry chair at Duke University’s medical school, added, “Mental disorders become the default position to deal with medical uncertainty. It's widespread, and it's dangerous."
What you can do
I think it’s important for patients and families to be aware of this problem and to keep it in mind, particularly when seeking emergency care.
If an ER provider tells you that it’s in your head, says you’re having a psychogenic reaction, or wants to prescribe anxiety medications, ask what other diagnoses he or she considered. Ask for a consultation with a specialist.
Beyond these points, this is another reason to have a regular primary care provider who’s familiar with you and your baseline health. See that provider for help as well.
We are here to help
If you or a loved one has been seriously injured because of poor medical, hospital, emergency, or labor and delivery, click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.
All consultations are free, and, because we only represent clients on a contingency fee, you will owe us nothing unless we win your case. We handle cases in the Houston area and all over Texas. We are currently working on medical malpractice lawsuits in Houston, The Woodlands, Sugar Land, Conroe, Dallas, Austin, San Antonio, Corpus Christi, Bryan/College Station, and Waco.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also, in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
