Darkness Visible: A Life of Chaos

a chaos of hard clay. Byron, Darkness Darkness Visible: A Life in Chaos It takes almost a decade to train a physician: at least seven years for a family practitioner and up to ten for cardiac- and neurosurgeons. We become technically proficient in treating diseases, but are not as adept at treating the illnesses that people present with. How often do we get, or make, the time to really get to know our patients? Physicians are comfortable with disorders that are clear-cut: diabetes, skin cancer, hypertension, and on and on. Yet, there is a subset of humanity with medically unexplained symptoms (MUS). Thirty to 50% of people seen by primary … Continue reading


MUDS: In Search of Medically Unexplained Dermatological Symptoms

MUDS EAJDVby David J. Elpern, M.D. Medically unexplained symptoms (MUS) are relatively well-known in the literature but not discussed in any dermatology journal. A recent book, Is It All In Your Head?: True Stories of Imaginary Illness, by by the neurologist Suzanne O”Sullivan is a readable and accessible resource. While studied in primary care, neurology and rheumatology, our PubMed review found no mention of medically unexplained symptoms in a major dermatology journal. Yet two surveys conducted in my office, each of of 100 consecutive dermatology clinic patients, found that ~ 20% had some form of MUDS. This rate is congruent with the estimated prevalence of MUS.  It appears that MUDS … Continue reading

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