Alice, I appreciate that you want to let my physician off the hook but she knew about B12 deficiencies. I was, in fact, anemic. My MCV, however, was in the normal range. We discussed that too. Since a B12 deficiency usually shows a high MCV and an iron deficiency a low one, they sort of cancelled each other out. Which is why she also ordered a peripheral blood smear.

Like my MG, I had a classic presentation of symptoms of a B12 deficiency. And my doctor was trained at the Mayo Clinic. She is also brilliant and listens to patients. She literally had no "excuse" for dismissing my concerns and she knew it!!

A B12 deficiency is actually very common. I personally do not believe it is a zebra. Pernicious anemia, maybe, but not a B12 deficiency. With all of the people taking antacids and acid blockers, I'll bet there are an increasing number of them with B12, iron, calcium and protein deficiencies.

I had three members of my family who were tested after I was and they were below 400. With symptoms. Of course, achlorhydria runs in my family.

I wish I could remember the name of the woman who did a study on food years ago that showed we are not getting the nutrients we think we are from it. B12 was not showing up in beef, for example.

I think it might be hard for physicians to admit that they have a boat load of prejudice when it comes to patients. Like my former pulmonologist, who admitted that she thought allergies were not a valid condition for adults - only for children. Once she had gained more knowledge of that, she obviously changed her mind.

The mistakes start in medical school. It just gets worse from there. There is no emphasis on creative/critical thinking; only on cramming two dimensional facts into a brain. There is such pressure to be "perfect" that no one can learn from failure. And fear of lawsuits might as well be tattooed on their foreheads.

I don't have all of the answers. Probably only a few. But when doctors keep failing over and over again, something is most definitely wrong. Massive rationalizations help no one. When I asked Dr. Weil in 2000 about this lack of critical thinking and no time for pathophysiology in medical school, he got really serious. He was quite concerned about what medical students are not being taught and that what they are churning out are not "thinkers."

Can you imagine how much better doctoring would be if doctors really thought of patients as part of their "team?" How refreshing would that be?