David D. Clarke - They Cant Find Anything Wrong: 7 Keys to Understanding, Treating, and Healing Stress Illness

First Sentient Publications edition 2007

Copyright 2007 by David D. Clarke, M.D.

All rights reserved. This book, or parts thereof, may not be reproduced in any form without permission, except in the case of brief quotations embodied in critical articles and reviews.

A paperback original

Cover design by Kim Johansen, Black Dog Design

Book design by Timm Bryson and Alfred Hicks

Library of Congress Cataloging-in-Publication Data

Clarke, David D., 1953

They cant find anything wrong! : 7 keys to understanding, treating & healing stress illness / by David D. Clarke.

p. cm.

ISBN 978-1-59181-064-3

1. Stress (Psychology) 2. Stress (Psychology)Health aspects. 3. Stress management. 4. Medicine, Psychosomatic. I. Title.

RC455.4.S87C553 2007

616.98dc22

2007013430

Printed in the United States of America

10 9 8 7 6 5 4 3 2 1

SENTIENT PUBLICATIONS

A Limited Liability Company

P.O. Box 1851

Boulder, CO 80306

www.sentientpublications.com

It is more important to know what sort of person
has a disease, than what sort of disease a person has.

Hippocrates (460 377 BCE)

CONTENTS

Many people provided generous support to the writing of this book. My immediate and extended family listened for countless hours and provided helpful comments. My patients answered the most personal questions and shared difficult moments of their lives.

Christine Kris showed me how to find the meaning in the smallest personal details.

David Fainer taught me that before ordering a medical test, I should always know what I would do for the patient if the test was normal or abnormal. He pointed out that if the answer was the same either way, then the test was unnecessary.

William Snape knows that stress causes real symptoms and that effective treatment is possible. Few physicians understand this as well as he does.

Harriet Kaplan was unsurpassed at finding and relieving the stresses that cause illness.

Ian MacMillan and Charles Zerzan know that the care of stress illness patients takes time and provided support at key moments in my evolution as a physician.

Barry Cadish and Sarah Willett devoted time and hard work to the manuscript far beyond the call of friendship.

The personal warmth, knowledge, experience, energy and professionalism of Mim Eichler-Rivas influenced every chapter.

My professional colleagues provide the finest medical care that I know. It has been a privilege to work with and learn from them. It is difficult to imagine another group of clinicians and nurses who could have supported my work with stress illness patients as well.

Lynn Hanson suggested some of the references in the appendix and Marlene Smith found the Hippocrates quotation that opens the book.

I owe a great debt to the people who reviewed the manuscript and provided thoughtful, detailed suggestions: Shirley Barker, Eileen Brady, Melanie Camras, Jack G. Clarke, Lucas M. Clarke, Vincent J. Felitti, Peter Fish, Linda Hedge, April Henry, Susan Hook, Marcia Liberson, Sharon Maxey, Linda Moraga, Sonya Richards, Herb Salomon, Stephen Stolzberg and Nancy Ward.

To honor the privacy and confidentiality of my patients, in telling their stories I changed their names, the names of family and friends and all personal details that could identify them. At times, I combined the experiences of two or more similar patients into a single story. All passages have been reviewed by the patients where possible prior to publication.

If you have symptoms, including but not limited to any that resemble symptoms described in this book, you should visit your doctor for a full evaluation. This book may be useful in discussing potential causative factors with your doctor but should not be used in lieu of medical advice from a health care professional. The reader agrees to hold the author and any agents, partners agents, licensees and assigns harmless from any liability, claim, cost, damage or expense (including reasonable attorneys fees) arising out of or in connection with the sale, transfer or use of this book.

The real act of discovery consists not in finding new lands, but in seeing with new eyes.

Marcel Proust

Its not what youre eating; its whats eating you.

Janet Greeson

E LLEN HAD LOST ALL HOPE. M ARRIED, IN HER LATE FORTIES, A MOTHER OF TWO teenage daughters, and a director of a major metropolitan library system, Ellen introduced herself by looking up from her hospital bed and saying wearily, Dont waste your time with me, Doctor. Theyve been trying to diagnose me for fifteen years and my tests are always normal. She went on to describe the pattern that her attacks followed, promising that this episode would be over in a few days. Then Ellen sighed and spoke words I have heard countless times in my practice: They cant find anything wrong! Evaluations by over a dozen specialists and sixty separate hospital stays at a prestigious university medical center had failed to uncover the cause of her debilitating symptoms or give her any relief. Fortunately, and much to Ellens surprise, a little over an hour later I was able to cure her illness.

You or someone you know could be suffering from a similarly baffling disease. Every year in the United States, health care providers receive hundreds of millions of visits from adults seeking causes and cures for a range of ailments. Incredibly, up to half of these patients remain undiagnosed and inadequately treated, because tests and examinations cant find anything wrong, even though the pain and changes in body function are perfectly real. Among the symptoms that patients like Ellen experience are:

• Pain such as headache, back pain, neck pain, chest pain, muscle or joint pain, and abdominal pain
• Abnormal swallowing, digestion, or bowel function including constipation, diarrhea, and bloating
• Nausea or vomiting
• Discomfort in the bladder or during urination
• Respiratory symptoms, including difficulty breathing and cough
• Voice changes
• Heart palpitations
• Pelvic and vaginal irritation, premenstrual or menstrual pain
• Fatigue
• Abnormal sleeping or eating
• Symptoms related to nerve function such as blurred vision, dizziness, ringing in the ears, itching of the skin, sweating, numbness or tingling

These symptoms are the bodys way of letting us know something is wrong. Diseases that we diagnose with tests also can cause these symptoms diseases we can describe as visible illnesses so it is frustrating as well as baffling when x-rays, scans, endoscopes, blood tests, and other studies cannot find the cause. Tragically, millions of patients like Ellen suffer symptoms from an invisible cause for years, even decades, without remedy, resolution, or relief. Now, however, this is changing. We have learned that by asking the right questions, it is possible to find answers and diagnoses, which lead to treatments and cures. After working in this field for more than two decades, with experience in diagnosis and treatment of more than seven thousand patients like Ellen, I can attest to the fact that real hope is on the way.