Capitaine Évident

“They certainly give very strange names to diseases.” – Plato

A person very important to me was recently diagnosed with epilepsy. During the appointment, the doctor talked about three different types of seizures which led to the diagnosis and the symptoms of each. Of course, I’m writing in the simplest of laymen terms as I remember them, so I can’t attest to the complete accuracy of my explanations.

First, are the Absence (French pronunciation – ‘ab-SAHNCE’) Seizures. These are brief episodes which generally go unnoticed except for the sense of “lost time”. One who experiences this type of seizure won’t necessarily notice any type of symptom or unusual feeling, but might have a blank spot in his or her memory of a few seconds or minutes.

Next are the Myoclonic Seizures. These are abrupt twitches and little jerks which can result in the involuntary dropping or even “tossing” of objects one is holding. One of the manifestations could also be a sudden mark across the page as one is writing.

Finally, we have the Grand Mal Seizures. These are the ones that come to mind for most people when they hear the word “seizure”. Grand Mal seizures include loss of consciousness which leads to collapse (most of the time). There are three stages to this type of seizure. The “tonic” stage is when the body goes rigid. The “clonic” stage follows and the body begins to convulse. The “postictal” stage is the final stage and is a deep sleep.

As the doctor was explaining all of this, my high school French came back to me and I started translating some of the terms he used. For example, “Grand Mal” means “big evil” and “Absence” means “not there”.

So, I began to hear his conversation like this:

“What we see here is evidence of Big Evil Seizures. These are Big. And Evil.”

“What account for these gaps in memory are what we like to call, ‘Not There Seizures’. It’s like you weren’t even there. Because you can’t remember it. I mean, if you had been there, you could. But… you can’t. Get it?”

So, I looked up some other words:

Myoclonic – from the Greek “mys” (muscle) + “klonos” (contraction)
Tonic – from the Greek “tonikos” (stretching)
Clonic – from the Greek “klonos” (violent motion)
Postictal – from the Latin “post” (after) + “ictus” (a blow)

So here’s what we heard:

“I’ve diagnosed this as epilepsy. The involuntary muscle contractions and twitches are caused by Myoclonic seizures. The memory lapses and lost time are explained by Absence seizures. The injuries the patient suffered were due to Grand Mal seizures. These injuries probably occurred during the Clonic stage.”

Here’s what he said:

“I’ve diagnosed this as epilepsy. The involuntary muscle contractions and twitches are caused by Muscle Contraction seizures. The memory lapses and lost time are explained by Not There seizures. The injuries the patient suffered were due to Big Evil seizures. These injuries probably occurred during the Violent Motion stage.”

It seems to me health care would be simpler if we did away with some of the terminology. For example, if one were diagnosed with cancer, would it make more sense to go see an Oncologist or a Tumor Doctor? (Then again, you’d probably feel more comfortable having an Obstetrician deliver your child than a Stand By Doctor.)

It sometimes feels like doctors purposefully obfuscate the diagnosis so we patients have no real clue what they’re saying. Most likely, it’s simply a way to save face. I mean, this guy spent four years in college, four years in med school, a year of internship and then three or four years in residency. There’s got to be some way to show it made a difference, right? I mean, saying “The patient complains of pruritus ani along with xerostomia and sporadic epistaxis” sounds a LOT better than “The patient has an itchy butt, dry mouth and sometimes gets nosebleeds”.

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