Got a feeling inside (can't explain)
It's a certain kind (can't explain)
I feel hot and cold (can't explain)
Yeah, down in my soul, yeah (can't explain)
I have been giving this some thought lately given the frequency with which chronic fatigue presents in the general infectious diseases clinic.
This article, published in the Journal of the Royal Society of Medicine (UK), explores how physicians manage unexplained medical symptoms. Thirty to fifty percent of symptoms cannot be well explained. Sadly, we are poorly trained to consistently approach these symptoms and engage patients in a meaningful, reassuring way. The result is an encounter which is unsatisfying for both doctor and patient.
All is not doom and gloom. There may be a partial solution, as published here. Targeted, focused teaching on the management of medically unexplained symptoms, over 2-3 hours per year, would be both well received and beneficial.
Can't explain should not mean that we can't reassure.
