Pria Anand

“In his wonderful TED talk “A Doctor’s Touch,” physician and author Abraham Verghese relates a story in which Bell divines the shortcut a woman took to travel to the clinic from the color of the clay on the soles of her feet and her job—as a linoleum-factory worker—from a rash on the fingers of her right hand.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“In the Salpêtrière, medical care was a quid pro quo, given in exchange for a performance of one’s illness. In modern emergency departments and hospital rooms, I have seen quieter ways we ask our patients to perform their illness in exchange for their care. A woman arrives in the emergency department three times in as many weeks, first with hazy vision in one eye, then with a heaviness that weights her right foot like a winter boot. Each time, she is perfunctorily examined and sent home with no explanation for her symptoms; in the chaos of an emergency department flooded with overdoses and heart attacks, her symptoms are too subtle to merit attention. The third time she is examined, she says that she cannot move her right leg at all, refuses to lift it when the doctor asks. This time, she cannot walk out of the emergency room to return home. An MRI shows the unmistakable white lesions of multiple sclerosis, unfurling like flames from the center of her brain. Given a name for her disease, a reason for her symptoms, she will later walk to the bathroom, bearing weight on her right leg. The weakness has retreated to just her foot. This sort of unconscious exaggeration is common enough that it has a name: medicine calls it elaboration, the inadvertent performance of a weak leg to receive care for a weak foot that would otherwise be overlooked.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains