General practitioners' perceptions of chronic fatigue syndrome and beliefs about its management, compared with irritable bowel syndrome: qualitative study

Why did it take a housewife to discover the Lyme epidemic?
What lack of scientific method, behavioral problem or mental flaw made
doctors oblivious to what a Polly Murray, a housewife armed only with an
arsenal of common sense could see so clearly?; That the "genetically
induced Juvenile Rheumatoid Arthritis" that doctors were diagnosing in
Lyme Connecticut occurred at a rate of increasing prevalence distinctly
uncharacteristic of a "genetic" illness.
Polly Murrays book "The Widening Circle" describes her battle against
doctors who insisted that the Lyme epidemic was "All In Your Head" despite
unimpeachable evidence to the contrary.
Even after the contradiction of the "statistically almost impossible"
increasing prevalence was pointed out to doctors, they still failed to
respond in a scientific manner.

Physicians have the audacity to produce "scholarly" papers on the
mental behaviors of obstinate patients who refuse their recommendations
for mental health interventions while evidence continues to mount that the
entire crisis of patient confidence is being created by the inexplicable
behaviors of the physicians themselves. Where are the studies that explain
these repetitive failures of a "common sense" approach in doctors?

No patient expects all doctors to be all knowing, but at the same
time, denial of incontrovertible evidence and skepticism in the face of
obvious abnormalities by a significant number of doctors is undermining
the credibility of an institution whose function absolutely demands it.
The errors of omission that are so consistently being made were the point
of a lesson by the renowned physician, Sir William Osler who taught his
medical students the importance of keen observation. A memorable example
occurred one day when he showed his students a small bottle of a patient's
urine and told them that "this bottle contains a sample for analysis. It
is often possible by tasting it to determine the disease from which the
patient suffers." He demonstrated this by dipping his finger into the
bottle and tasting it, after which he instructed his students to do
exactly as he had just done. The students, with some trepidation and each
in turn, dipped their finger and sampled the bottle's contents, trying to
determine what important lesson they were about to learn. Osler surprised
his students by holding up the bottle and saying, "Now you will understand
what I mean when I speak about details. Had you been observant, you would
have seen that I put my index finger in the bottle but my middle finger
into my mouth!"

I believe that any physician who survived a course of study under Sir
William would have seized upon the clues that modern day doctors overlook
in favor of total reliance on their catalog of lab tests. It is the power
of observation that distinguishes a diagnostician from a pill purveyor.
It is training of the sort that Sir William Osler conducted which is
required to stem the crisis in confidence created by those doctors whose
practice includes medical malfeasance.
-Erik Johnson

Competing interests:
None declared