Relaxing From the Symptoms



S.Q. Lapius always maintained a discreet silence when I sprinkled the food grains into the tropical fish tank on the theory that since he didn’t enjoy being disturbed while eating, the fish harbored the same prejudice.  The fish were a new addition to the ménage.  A substitute for color television.



When Lapius had successfully parried my arguments in favor of color TV, I was reduced to the contention that it would add some color to the room.  “If it is only color that you want I have a better solution, and much quieter too.”  Lapius said, and the following day an aquarium resplendent with iridescent fish, appeared.



“Of course you will have to take care of them and clean the tank since it is you who wanted them,” Lapius informed me.  It was useless to remind him the I didn’t want the fish in the first place.



The fish hypnotized him and he would stand for hours watching them undulate in the water.  As soon as I had finished feeding them he took his position in front of the tank.  “See if you can get me a news program,” I suggested.



“After a hard day in the office this is just the type of silent relaxation that I need.”  Lapius murmured. 



“What is so hard about a day in the office?”  I asked..



He spoke with his back towards me, his eyes glued to the aquarium.



“Oh, it’s something I run into every winter, Harry.  The patients grill me.  They want to know the cause of their troubles.  Why does my arm hurt, what is the cause of bursitis, do you think the headaches could be nerves, which food caused me to belch?” 



“But, of course, you patiently explain these matters, don’t you?”



“Bah, Harry.  Explanations in medicine are impossible, because each answer brings up new questions.  You know that.”



Lapius tapped on the glass and watched the fish prance.  “At least,” he said, “in the old days when they were testing atomic bombs, I never got questions like that.”



“What have atomic bombs to do with it?”



“Everything, Harry.  Then, when patients came to the office with a complaint, they would say, ‘I guess it’s due to atomic radiation, eh, doctor?’   I would nod wisely without saying anything.  Patients like to have a cause for their suffering.  Not a deep scientific cause, but something they can relate to their day-to-day affairs.  You have those patients, don’t you Harry?”



I nodded wisely, but Lapius had his back towards me. 



“I thought you did Harry,” Lapius continued.  “Don’t you have those nervous women who can’t take any medications?”  



“You mean when every medication you give causes a symptom?”



“Precisely, Harry.  These people are neurotic, with a storehouse full of symptoms; nausea, diarrhea, tingling of the toes, headache, blurred vision.  Every time you prescribe something they pull one of these symptoms from their repertoire and the next time you see them they tell you the medicine made their eyes burn or their hands go numb.”



“What happens when they are not on medication?”



“Oh then it’s different.  Their hands burn and their eyes go numb.”  Lapius chuckled suddenly.  “I recently was called to attend a man in shock from a sudden heart attack.  He was cyanotic, his pulse was racing at 150 beats per minute.  He was gasping for breath.  He was close to death.  His wife came over to me and said ‘I told him not to eat that fish.’”



I laughed.  “Sure Simon.  I recognize that breed.  We all have those patients.  But why are you so suddenly afflicted with them?”



“Not suddenly, Harry.  But it always gets worse after the summer.”



“What’s so special about summer?”



“Oh, during the summer they have air-conditioning.  Whatever they come to the office with, they blame on the air-conditioning.  The lame shoulder – ‘Doc, don’t you think it was because I was laying near the air-conditioner?’  Or the diarrhea, ‘I knew I shouldn’t have kept the air-conditioner in the bedroom.’  The air-conditioner offers an immediate cause for all summer complaints.  But in the winter they can’t figure out why they get sick, and keep asking me all these confounded questions.  After all, Harry, we really don’t know the reason for a lot of things, do we?  We don’t know what causes migraine, nor can we really explain epilepsy, etc. etc.”



Lapius was still staring at the fish.  “Honestly, Simon,” I said, “wouldn’t we be better off with a color TV?  At least once in a while it would say something.  Occasionally there is even a football game.”



“Absolutely not, Harry,” Lapius said emphatically.  “Color TV makes my eyes water, and usually gives me a headache.”