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Several years ago I suffered from reflex sympathetic dystrophy, a painful and uncommon sympathetic nervous system disorder that can be disabling. It was still possible to find references to it on the net that called it a psychiatric disorder, although by that time it had been generally recognized as a physical disorder with an accepted course of treatment. One of the treatments is physical therapy, which my doctor prescribed twice a week.

The physical therapy really helped, though I ended up devising my own regimen that included running up and down the stairs whenever it flared up (in the middle of the night if necessary) and alternately roasting and freezing my leg in a hot spa and cold pool. Combined with anesthetic shots in my spine, I was able to recover and put it behind me. Three years later, I only remembered I had it when I met someone whose 13 year old granddaughter was in a wheelchair because of it. My great good fortune was that my doctor listened carefully to me as I described symptoms that had nothing to do with his specialty, and was up to date on the research that established it as a recognized disease process. A delay in the diagnosis would have subjected me to additional pain and reduced odds of complete recovery.

Another time, I noticed a lump in my cheek and went to a doctor who diagnosed it as a parotid (salivary gland) cyst, refused to biopsy it in spite of my repeated requests and said if it didn’t grow it wasn’t cancer. That was best practices care 20 years ago, but when I went to another ENT two years later, even though it didn’t feel like it had grown, the first thing this up-to-date doctor said was, “let’s biopsy that right away.” It was cancer, and in the intervening two years it had grown on the inside, wrapping around my facial nerve. Fortunately, my surgeon was brilliant, had the latest nerve monitor and superb skills and I have recovered with remarkably little aftermath, especially considering all the radiation I needed because it had spread so far.

I was lucky with my cancer, that it wasn’t too late by the time I consulted the second doctor, but there is no question that finding a doctor who invests their too scarce time in keeping up to date on best practices has a profound effect on the outcome.