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Few things in medicine are harder than trying to explain to a patient that you don’t understand what is going on. As is common, I recently had an adolescent patient that had either psychosomatic stroke symptoms or actual acute resolving weakness exaggerated by anxiety. As we very gently let him down, we explained that we could not find a physiologic reason for his weakness, now better, and that we would likely never know what caused it. All the patient often hears in these conversations is a booming, “It’s all in your head.” So it was under these conditions that the patient caught me off balance. “How can you not know, you have been studying this stuff for your entire life?!”
Avicenna, legendary Islamic physician and philosopher
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