On the contrary, Alice, I know there are many causes for what's going wrong with doctoring!

When I had my B12 deficiency, for example, I was going to an internist whom I had known for well over a decade. She KNEW me. I kept going to her, telling her how tired I was. So tired that I felt sick. She kept saying, "There's nothing seriously wrong with you." I was so tired that I had to quit my job over it. It ended up being my last full time job.

I was so scared and frustrated that I bought my first medical book. I figured that I could at least put myself through a crash course on the causes of fatigue. The medical book didn't even have the reason I was sick in the "fatigue algorithm," which I didn't know until after I figured it out. I sought out 2nd opinions but no one knew what was going on.

I brought that info back to my internist, along with my suspicion of having a B12 deficiency. She wouldn't even test for it. So I then put my thoughts in writing and she finally agreed to run the test. About a week later, she had put a message on my voice mail that I had a B12 deficiency - please call for an appointment. I also had a high homocysteine level.

I had parasthesias, some of which never went away because treatment took too long. I was feeling faint all the time. I could not stay awake. I had early onset dementia. For a doctor who had practiced that long and was so smart, she should not have been so dismissive of my concerns.

So that situation only took two years, a bunch of doctors, lots of money, a loss of a job and so much more than I can express - like a loss of trust - and I still didn't know WHY I got the deficiency until a few months later. And I honestly believe that it is during this time period when my lifelong MG took its turn for the worse. As you know, you need B12 for the acetylcholine biochemical pathway.

I did BEYOND what most patients do to help themselves. I KNEW my doctor and she KNEW me. I was crystal clear about my symptoms. I sought out the second opinions. Ironically, it was when I asked my Mom if any of my relatives had been as tired and sick as I was when she told me that my Uncle had pernicious anemia. I didn't have PA but a lack of stomach acid causing my deficiency. But when I read the symptoms of PA, I KNEW I had a B12 deficiency. It just "fit." I've trusted my instincts about medical issues over a doctor's facts ever since.

I don't have unrealistic expectations of doctors. And, I should add, that even though I felt the need to move on from that doctor years ago, she is STILL my internist. I FORGAVE her for being human and moved on.

And she apologized to me. She now considers a B12 deficiency anytime a patient is tired.

Also, I have very good doctors but even they have to work within a very imperfect system. I have known my doctors for a LONG time.

So, PLEASE, don't assume things about what I, as a patient, have been willing to do, to put up with, to work towards to have the very BEST relationships with doctors.

And what about patients who don't have a medical interest, who don't know how to figure out what's wrong and who can't afford to keep going to a doctor over and over again? I honestly believe that there are many doctors who are not trained to be good diagnosticians. Should we all simply sit at home, waiting to die because we expect to get help when we see a doctor? I know doctoring is not as easy as making a "wish" but it should NOT be this hard either!!!

Annie