How do you sue without suing?
September 20, 2007 3:16 PM   Subscribe

I was misdiagnosed and found out after a lot of pain and money from a different doctor that I have an STD.... uh, should I sue? This is long, so if you're of the tl;dr crowd, bypass please.

This has never entered my head before today, and I'm not even sure if these are valid thoughts. So I wanted to bounce this off of my AMF comrades, instead of just rushing off to a law office.

In late June, I noticed a small red bump near my bikini line (I'm a chick). Quite honestly, I thought it was an ant bite - I had been in the garden sunbathing the previous day, so I didn't think anything of it. I woke up the next morning to find that there were now two bumps instead of one, and the first had started to harden a bit. Again, I thought nothing of it. Maybe I didn't notice the second one the first time.

But I started worrying a bit after a while. I spoke to a friend of mine that's older and more experienced in the ways of the world, and she said, "uh, get to the doctor NOW. it sounds like herpes."

Immediately, I launch into "omfg my life is over WTF HOW DO I GET RID OF IT SHORT OF CUTTING MY BITS OFF?!?!?!?"

I don't have insurance, so I went to one of those urgent care clinics they have around. I told the girl on the phone what's what, and she said, "come in now. we can take you as a walk-in."

I went in, and was soon greeted by a female nurse. I told her the issues at hand, and she was noncommittal. She left, and soon brought in a very nice doctor who was extremely charming and made me feel like I wasn't a leper - which is what I was expecting.

He looks for maybe 20 seconds, pokes and prods, then says, "ok, get dressed and I'll be right back.... no, it's not what you think, I promise." He comes back in after I've dressed, and he has a book with him (I assume it's something like a PDR) and starts to read from it. The passage mentions red bumps, no fever, no swelling, hurts to the touch.... it SOUNDS like what I have. He says that same thing and I agree. He tells me the name - to be totally honest, I really do not remember. It was a really long, medically sounding name that I didn't recognize at all. The doctor gives me a prescription for a Z-pack to kill the infection, and a shot of some whatever stuff. to help it along. I thank him, pay my $140+ bill and leave.

On July 3rd, I notice that the bumps have multiplied and appear to be draining. Oh, and I'm in a massive amount of pain when I pee. I'm a little worried, so I call back in and ask to speak with Dr. Charming. I'm put through to a nurse, who tells me "here's a prescription of hydrocodone for you to take. It'll take roughly 10 days for the infection to go away - it'll get worse, then get better. Call us back in a few days and we'll get you in." I take the prescription and start limiting my fluids so I don't have to pee.

On Friday, July 5th, it's horrible. Most of my lower nether region area is covered in white blisters. By this time, i can't even MAKE myself pee - as soon as I attempt to, I get greeted with the most disturbing and horrific pain I've ever felt... and I've woken up without anesthetic during a wisdom tooth removal before, so I know pain when I feel it. I've dropped about 5lbs and I can't force myself to drink anything for fear that I can't hold it and have to spend 30 minutes sobbing just to pee a tablespoon of urine.

I show up to the clinic again. The doctor, once again, isn't around. I see a nurse who takes one look at the blisters and leaves immediately. She brings another doctor in who tries to lighten the mood, but fails miserably. She begins to do a culture on the blisters, and I just fall apart - it hurt so much, I couldn't stop from screaming. She says that she can use a catheter and help me empty my bladder. I knew it would hurt, but I had no choice. Again, more screaming. The nurse - god bless her - rinsed me off because I'd been in so much pain that I had to avoid water "down there". She leaves while I get dressed, and when she comes in, I can tell what she's about to say. I already know the diagnosis - I have herpes.

She tells me that she's almost positive that it's herpes, but they'd send the culture off to double check. She gives me a dozen samples of Valtrex, and a prescription for a few more days' worth, as well as another prescription for hydrocodone. She also arranges for me to speak to a ob/gyn on Monday.

I was physically not able to go to work on Monday, as I was in too much pain. I couldn't sit, and could barely stand. Wearing anything but pj pants? Forget THAT. I did go to my new doctor's appointment, though, and she confirmed on sight - it IS herpes. She even commented that when she was looking over my file, she could not believe I was not diagnosed from the get-go.

Two weeks later, I received a phone call from the first doctor's nurse. "Oh, yeah, btw you have herpes. Just letting you know." Not those words, but that's what it felt like.

[ I'm not going to mention about all the mental turmoil I've gone through, because you guys normally mention that the OP shouldn't have mentioned that and tainted the overall incident with emotion. I tried to keep it out as much as possible. ]

Ok, so it's now late September. I'm adjusting to the medical side of things. I'm only just now recovering - because of the length of time I went undiagnosed, I had what my new gynecologist called "a very severe case" and my skin "down there" is just NOW thickening to the point of not tearing when I use toilet paper. All of July and August was spent on pins and needles - I wasn't able to use the bathroom without pain until the first of August.

I've spent close to $2k on doctor visits and medications (including a cream that is $125 for a small tube - like, American dollars... not pesos). My current state of mind? If I wasn't borderline depressed before, I'm definitely that way now. And sex? Forget about it. Maybe because I have herpes, maybe because I don't want my boyfriend to get it, or maybe all of the pain I was in, I dunno - but haven't had it and don't want to.

I'm not asking for financial retribution per se - I'm not one of those people that is demanding full payment of my treatments past and present. But I can't help but think that if I had been diagnosed on that first visit - the one where he said there's NO WAY I HAD IT - I could have saved a lot of money on my medical bills, I wouldn't have been in so much pain for as long as I was, and I probably would not be so damn depressed and jumpy now.

So, my question to all you me-fites out I crazy for wanting the doctors at that clinic to understand what they did to me? The trauma - physical, mental AND financial - that I've been through? Suing someone has never entered my brain until today, and only then it was a "those bitches need to understand!" and not "those bitches need to pay!"
posted by anonymous to Health & Fitness (40 answers total) 1 user marked this as a favorite
A lot of people go into lawyer's offices saying "I don't want money. I just want vindication." Well, courts don't deal in vindication or right and wrong or closure or any of that crap. They deal in money. If you go to a lawyer, he or she will try to get you money, and (I am not your lawyer, I don't know what State you're in or the laws there) if he or she is worth anything will be able to do so. They may demand an apology or something, but money is about all they can do for you.

However, there is nothing wrong with wanting to be compensated for something like that. They deserve to suffer a consequence for their negligence (as a motivation to prevent them from letting it happen again) and you deserve compensation. Money is the only way to do that, so there is no reason to turn your nose up at it. Go see a plaintiff's attorney that specializes in medical malpractice (ask around or contact your State's bar for a referral). I don't often say "Go see a lawyer right now!!1OMG!1" on AskMe, but this is one of those times.

Oh, and sorry that happened. That sucks.
posted by ND¢ at 3:29 PM on September 20, 2007 [1 favorite]

Maybe try and get reimbursed for the unnecessary payments. But please don't sue just because you're angry. It makes doctor visits more expensive for everyone else.
posted by greta simone at 3:33 PM on September 20, 2007 [2 favorites]

You're not crazy, but you're grieving and you're recovering from a lot of pain and you're justifiably mad and you want retribution.

You won't get it, though.

The people who practice medicine can't walk around in constant fear of making mistakes - and they will, repeatedly, make mistakes, no matter how hard they try not to - because you can't do a quality job at all if you're nothing but hesitant and anxious. They develop a certain shell, one that is both necessary and detrimental to performance, and so you are only going to get a very detached sort of sympathy if any. One or more people involved in your case understand perfectly well, medically, what you went through. They may not care, you can't make them care, or they may care but need to carry on functioning and so don't dwell on your misdiagnosis every night, and you can't force them to dwell.

You've been through a shitty thing on a number of levels, at least one of which is bureaucratic. You can report them to whatever governing bodies are responsible for medical practices in your county/state, if they are a corporate entity you can complain to their administration, but you can't personally punish them. The energy, once the letter writing is done, is probably better spent directed at getting better, physically and mentally.
posted by Lyn Never at 3:53 PM on September 20, 2007

Why not just write a letter to the doctor who made the mistake? Heck, print this post out and send it to him. That way he could understand what your view of what happened is. He probably knows that his initial diagnosis was wrong but not what that has ended up meaning to you.

I'm sorry to hear about what happened to you, by the way. It sounds terrible.
posted by ikkyu2 at 4:06 PM on September 20, 2007 [1 favorite]

Also, I don't agree with greta simone. I don't know if you have a case here - I'm no lawyer - but I do know that every doctor is aware that if they screw up badly enough, they get sued. Docs pay for malpractice insurance to insure against these suits.

The costly part to society is not when someone brings a meritorious suit against a bad doc. The costly part to society is when a bad doc screws up many people's lives, leading to needless and preventable disabilities, deaths, pain and suffering, days lost from work - and no one calls him on it. Eventually a doc who keeps screwing up won't be able to get malpractice insurance, which means they won't be able to maintain a hospital or clinic affiliation. This is bad for that doc and good for a bunch of lawyers, but it's probably also a net good for society.
posted by ikkyu2 at 4:10 PM on September 20, 2007 [8 favorites]

I feel for you so much. That sounds just awful. I don't think you're crazy for considering suing for malpractice, and I am about as un-litigious as they come. It's definitely worth talking to a lawyer.

The clinic may not have provided the best possible care, granted. However, they were not the direct cause for your "physical, mental AND financial" pains. They definitely didn't help you cope with them as best they could. They without doubt contributed to them. However, they were not the direct and necessary cause of it. That blame lies elsewhere. Just something to keep in mind.
posted by milarepa at 4:11 PM on September 20, 2007

Assuming that you are in the US (since you mention US dollars), there are a lot of proposed laws to shelter doctors who apologize from being sued for malpractice. One article:

Apology laws vary by state. In Arizona, Connecticut, Idaho, Maine and 11 other states, doctors can safely apologize to or commiserate with patients or their families about an undesirable or unexpected outcome, according to the AMA.

A law in Vermont exempts only oral statements of regret or apology, not written ones. Illinois gives doctors a 72-hour window to safely apologize after they learn about the cause of a medical mishap.

I realize that you aren't looking primarily for an apology, but the issues raised are similar as in your case -- is there any way for them to admit fault without exposing themselves to financial liability? If not, they are unlikely to do so, I would guess.
posted by Forktine at 4:17 PM on September 20, 2007

Don't go see a lawyer. Don't sue the doctor. Don't be one of those people who sue for something frivolous like this. I don't understand, from the description of the problem, what you're alleging the doctor did wrong --- the clinic was initially wrong, but you're talking about a difference of a few days. You noticed the initial symptoms in late June, and you were correctly diagnosed on July 5. The fact that the clinic didn't IMMEDIATELY diagnose the herpes correctly is not necessarily malpractice.

The fact that the doctor initially misdiagnosed you does not mean that the doctor has harmed you. The question of whether the doctor committed malpractice involves complicated inquiries that it isn't really necessary to go into here. But you'd be wasting everybody's time, you'd be harming the doctor without cause to do so, and frankly, you'd be deeply foolish going into a lawyer's office with this.

Doctors are sometimes wrong, despite having exercised every degree of care that they could have exercised. Sometimes diseases present themselves in ways that strongly resemble something else, and 99 out of 100 highly competent non-specialist doctors (like the one you went to) would have made the same mistake.

Malpractice suits are appropriate, in my opinion, where there's serious, long-term damage inflicted by a doctor's clear violation of a standard of care ... serious screw-ups with lifetime, crippling consequences. Most medical malpractice suits are completely bogus attempts to extort money from deep-pocketed defendants. Most medical malpractice suits are scummy plaintiffs with dollar signs in their eyes, who can barely flip a burger without screwing it up, committing legalized extortion against highly trained, compassionate professionals. I'm not saying you're one of those scummy plaintiffs, but based on what you've said, if you moved forward with a lawsuit like this, you'd become one of those people.
posted by jayder at 4:29 PM on September 20, 2007 [3 favorites]

Focus your energy on getting better, not on retribution.
posted by foobario at 4:30 PM on September 20, 2007

I couldn't agree more, jayder.

Look at it this way. You don't have insurance, so if he had ordered an exhaustive array of tests for something trivial, you would have been pissed off and broke.

The doctor made his diagnosis based on the best information available to him at the time. He wasn't willfully hurting you. He wasn't trying to make you suffer.

Poster, I think you should examine why you're really upset here. You have herpes and it sucks. Nothing any doctor can do will change that.
posted by chrisamiller at 4:41 PM on September 20, 2007

god, i know how pissed you must be. i had an undiagnosed back injury for about a year before i got the right therapy for it.

the problem with medicine is that it's as much an art as it is a science. it's harder to diagnose a disease than a broken arm, unfortunately. mistakes happen, even if a doctor does all the right things.

i think jayder is right. a mistake does not equal gross negligence. however, it does suck that you went through that. i would write to the doctor and maybe to the parent company of the doc-in-the-box. it may do some good. also, you might seek out a therapist to help you deal with those emotions.
posted by thinkingwoman at 5:22 PM on September 20, 2007

I feel for you. You convey the pain you've been through remarkably through your words. But I do wonder if your anger is somewhat misdirected here. Yes, it sucks to have what sounds like an awful case of herpes. Yes, a healthcare system where half the population is uninsured, and the other half can't get their insurer to do their jobs, sucks and costs people a lot of money and grief.

But by your own admission, what you had evolved with time. You saw a doctor who sounds like he was doing nothing but trying to help. He saw the very early stages of a skin lesion and did his best to make a diagnosis and treat you. He even brought in a textbook that suggested, with your agreement, that this lesion looked like something else at the time. That goes above and beyond what most people would expect from a one time urgent care visit. Short of pictures taken at that time, it's impossible to know if what you had at your first visit was an obvious herpes lesion that any health care practitioner would have been expected to recognize, and my suspicion is that as a result, legal action would probably only cost you more money, time, and discomfort. I'm not a lawyer however, and if you really think that going to one is going to make you feel better, rather than drag this out, then make an appointment.

Keep in mind, this doesn't sound like it was a continuity practice. Many doctors who work at urgent care centers aren't there every day, and the downside of urgent care is that it's not suited for continuity. "Dr. Charming" may work at this facility once a month. Also please do step back and ask yourself why you call him that and how gender dynamics are affecting your circumstances, as it may be quite revealing. You are angry that he was wrong, and of course he was. And had he been right, it's true -- perhaps an earlier course of the right medicine might have saved you some pain. But the question is, would any other reasonably trained person in his shoes at the time been expected to have acted differently? And to me, the answer to that is unclear.
posted by drpynchon at 5:23 PM on September 20, 2007 [2 favorites]

Since you don't have insurance, you may want to look into getting Zovirax (Acyclovir). It's available in generic in both pill and topical form.

The patent for Valtrex (Valacyclovir) is up on 12/23/09. There is also Famvir (Famicyclovir) but it will not be available as a generic at least until 2014.
posted by pieoverdone at 5:25 PM on September 20, 2007

Eventually a doc who keeps screwing up won't be able to get malpractice insurance, which means they won't be able to maintain a hospital or clinic affiliation. This is bad for that doc and good for a bunch of lawyers, but it's probably also a net good for society.

ikkyu2, does liability insurance increase due to a lawsuit being filed, or due to the outcome?

Alternatively is there any sort of arbitration device, outside of the court system, that can help determine if this is a frivolous case or not? Some sort of conduct board that the poster would be able to consult without retaining an attorney?

A failed lawsuit can cost quite a bit more than a $125 tube, and this is not a clear case of malpractice ... which is why we are being asked here I suppose, but it seems a more professional organization could fill this role without burdening our health care and legal system with additional costs.
posted by geoff. at 5:26 PM on September 20, 2007

Sounds to me like this is an example of not having insurance meaning not having proper care.

Talk to a lawyer. I'm sorry, this whole thing is unacceptable. PLEASE at least put the fear of God into this doc.
posted by konolia at 5:30 PM on September 20, 2007 [1 favorite]

OH, and just to let people know, I have been to these walk in clinics (once for a presumed ear infection) and the doc who was working was a PSYCHIATRIST moonlighting.
posted by konolia at 5:32 PM on September 20, 2007

Following up, WalMart does not have Acyclovir on it's 4.00 generic plan, but Target does. Acyclovir 200mg #30.
posted by pieoverdone at 5:33 PM on September 20, 2007

Seems like a better bet to sue the person who gave you herpes. If that was your first outbreak, you were probably infected in the month previous. If someone gave it to you knowingly, you may have a case against that person. Of course, IANAL. I'm sorry, it really sucks. But outbreaks after this (if they happen at all) probably won't be as severe.
posted by Ollie at 6:24 PM on September 20, 2007

Oh wow. It sounds awful. Even if it doesn't end up being lawsuit material, I don't think what you're going through should be called frivolous!! I am so sorry you are suffering with this and I hope that it won't last much longer!!
posted by Salamandrous at 6:36 PM on September 20, 2007

A failed lawsuit can cost quite a bit more than a $125 tube

It's my understanding that medical malpractice is usually handled on a contingency basis (the attorney's fee comes out of your winnings, you don't pay them directly).

I've got mixed feelings on this, but I feel that an initial consultation with a plaintiff attorney won't hurt.
posted by onalark at 6:52 PM on September 20, 2007

Seems like a better bet to sue the person who gave you herpes. If that was your first outbreak, you were probably infected in the month previous. If someone gave it to you knowingly, you may have a case against that person. Of course, IANAL.

Thank god for that. What the fuck are you talking about?

About the OP's experience - I, frankly, am quite surprised the first doc didn't immediately do a herpes serology if the presentation is what you described. I think that it should have been almost a no-brainer. That said, I don't really know that you have much more recourse than writing a letter to that doc and expressing what you've expressed here. He needs to know, and might rethink his cavalier attitude.

I am so sorry, by the way - it sounds utterly horrible.
posted by tristeza at 7:14 PM on September 20, 2007

The poster states that the OB/GYN she saw thought it should have been diagnosed as herpes from the get-go. It's entirely possible that the first doctor was negligent, and that a different doctor could have avoided the poster a lot of pain and money. If one out of 5 people has herpes, shouldn't a doctor be able to recognize it? I don't see the harm in talking to a lawyer.
posted by chelseagirl at 7:27 PM on September 20, 2007

does liability insurance increase due to a lawsuit being filed, or due to the outcome?

Strangely, no.

OP: You could call a lawyer, but they wouldn't really be interested. You have miniscule damages. The defense is easy: at an early stage disease A presented as disease B. Because you didn't have insurance, there wasn't much follow-up. The person who actually made a mistake appears to be the nurse from the third. A nil payoff and a long shot of success? There are many cases with actual gross misconduct and loss of life and limb to pursue.
posted by a robot made out of meat at 7:49 PM on September 20, 2007

ikkyu2, does liability insurance increase due to a lawsuit being filed, or due to the outcome?

I have no idea. I try not to think about these kinds of things.
posted by ikkyu2 at 8:39 PM on September 20, 2007

ikkyu, with all due respect it's a certainty that we all order way too many diagnostic tests for fear of getting sued. Few diagnostic dilemmas are allowed any time at all to mature and be worked-up in a logical, paced manner any longer because of a fear of litigation. But I agree with everything you said. Bad doctors are a scourge.

anon, you may indeed have a case if you can prove that delay or missed diagnosis resulted in harm, but it will be a hell of a slog. No matter what you need to write a letter to whoever is in charge of his clinic, and consider the doc himself as well. I need to say, also, that many posters here that are telling you to get over it are missing a critical element of HSV, and that is early treatment can result in a considerable decrease in pain, and vice-versa. I've seen a few first-time HSV outbreaks and they can be truly, horribly awful, physically and psychologically. At the very least you ought to have been counselled to follow-up if the rash worsened or took on further characteristics of HSV.

FWIW, the first one is usually the worst. Make sure you always, always carry a full prescription of anti-HSV treatment with you, especially on vacation.
posted by docpops at 8:39 PM on September 20, 2007

Seems like a better bet to sue the person who gave you herpes. If that was your first outbreak, you were probably infected in the month previous. If someone gave it to you knowingly, you may have a case against that person. Of course, IANAL.

This is why askme needs a glassing. There's no way to tell who gave you HSV unless you just unwrapped your genitals from Saran Wrap a week earlier.
posted by docpops at 8:42 PM on September 20, 2007 [2 favorites]

konolia: Um, psychiatrists are fully trained medical doctors. That's what separates them from psychologists. They should be as good at diagnosing and treating your problem as any other MD working outside his field of specialization.
posted by Joakim Ziegler at 10:11 PM on September 20, 2007

You said you want them to understand rather than wanting a payout. So write to the doctor (send a copy to the clinic), tell him what his misdiagnosis did to you, and ask for an apology. Even if he doesn't actually apologize to you (and he should) he will at least be more careful the next time someone comes in with your symptoms.
posted by happyturtle at 12:40 AM on September 21, 2007

to all the people ragging on Ollie for suggesting the OP sue the person who gave her herpes...

it may not have been a serious suggestion, and i certainly think it would be ridiculous to pursue it, but you have to know it would be totally feasible.

people have successfully sued for this in the past. not only that, but it is apparently illegal in many states not to disclose knowledge of your STDs to your partners. in other words, it could be a civil AND a criminal case. we don't know how many partners she's had, so for all we know it could be completely obvious who did it.

again, i am not suggesting she do this. but i don't think the comment deserved such ire.
posted by timory at 5:47 AM on September 21, 2007

I am so sorry that you have been feeling pain and discomfort. It sounds awful.

The first doctor may have been more accurate in his diagnosis if he had ordered lab tests. Which are hella expensive. Did you tell the clinic that you had no insurance? Would you have paid hundreds of dollars for lab tests during that first visit?

The system of paying for health care in this country sucks. Hands down, no question. Which leaves doctors at a loss when they can't use the diagnostic tests that might lead to a more efficient, accurate diagnosis. Maybe this was a bad doctor, maybe it was a good doctor. But I can see a situation where a patient doesn't have the ability to order tests and pay for them, and a doctor can't do a timely and accurate diagnosis without them, and everyone loses.

I'm frustrated for you...and all of us.
posted by jeanmari at 6:02 AM on September 21, 2007

That sounds horrible.

I work at an STD clinic, so I have some experience with issues like this. No one else has mentioned that the diagnosis of HSV is tricky precisely because at different stages HSV looks like different things. A confirmatory lab test is necessary for a definitive dx, and that takes some time. It takes more time at clinics more attuned to cost-consciousness and less attuned to customer service.

It sounds like the presentation of your HSV at the start was not sufficient to get you treated presumptively (that is, without confirmation). But, a swab was taken, it sounds like, since they eventually called you to tell you that you have herpes. This isn't a speedy process, and your outbreak was unusual.
posted by OmieWise at 6:21 AM on September 21, 2007

They should be as good at diagnosing and treating your problem as any other MD working outside his field of specialization.

Which is to say not very good at all.
posted by docpops at 6:57 AM on September 21, 2007

I agree with those saying to write to the clinic. Write strong words, tell them how you feel and how their actions made you feel. If you want to, go ahead and ask for refunds for the visits that contributed to the problem. The worst they can do is say no. And maybe they'll acknowledge, apologize, or do something to make you feel a teensy bit better about your painful and difficult experience.
posted by bassjump at 12:05 PM on September 21, 2007

In my defense: I was saying that if she wants to go after someone, go after the person who really wronged her. People have sued for transmission of STDs and won. Not that this would be easy or even a good idea, but then, neither would a malpractice lawsuit. But at least she'd be punishing the person who did the harm in the first place.
posted by Ollie at 12:54 PM on September 21, 2007

The first doctor misdiagnosed a serious progressive condition and caused you extended pain and suffering, physical and mental. Arguably, the exacerbation of the condition cost you money as well. Maybe not much, but enough that a settlement might be possible. A lawyer will certainly consider your story and give you a free consult and good advice. Just remember that in medicine, these days, money is justice. No matter what people say above, this is not a "frivolous" situation. That doctor fucked up.

But you have another route: complain in writing to the state medical board (it may have various names). They investigate such complaints and if fault is found, it goes on the doctor's record. So you can get some justice that does not involve money here.

Writing to the clinic for anything other than a refund is a waste of time. On strict legal advice, they are unlikely to say a thing acknowledging any responsibility to you.

Now you know something about what passes for medicine in those U-Pay walkin clinics.
posted by fourcheesemac at 10:55 AM on September 22, 2007

With due respect fcm (whatever that may be), herpes is not by most medical standards, a "serious progressive condition." It's a disease that is quite commonplace, virtually never life threatening in your average person with a working immune system, and is typically self-limited -- as opposed to "progressive." This was no doubt a terrible case of it, but adding to the needless stigma that already exists isn't very helpful.
posted by drpynchon at 12:19 PM on September 22, 2007

An untreated outbreak of a viral infection is serious and progressive whether it's HSV or Avian flu. Of course it's self limiting, but suppurating sores and intense pain reported by the OP are not necessary if treatment is administered promptly, which of course depends on diagnosis and follow up. Just because a disease is "common" does not mean it is not serious.

Not to mention the *serious* risk of transmitting the disease to others (who would damn well consider it serious, as the OP does) while not knowing what it is you have and how contagious it might be.

Sure, the doc could easily mistakenly misdiagnose it on visual presentation. But assuring the patient that the symptoms are "not what she thinks" and sending her off with a few antibiotics is another story. When she called back and described the symptoms reported here, she was told not to worry, that it would get worse and then get better on the X-pack antibiotics.

They should have said "get right down here for another exam."
posted by fourcheesemac at 7:32 AM on September 23, 2007

Well, if you're willing to call all viruses serious and progressive, I guess we're going to have to agree to disagree on semantic grounds. But, I agree that someone should have checked out the rash when she called in on follow-up.
posted by drpynchon at 12:12 PM on September 23, 2007

Late on this but . . . .Er, drpynchon, would you not consider some viruses -- let us say, HIV or Smallpox -- both serious and progressive? I do believe both progress, frequently, to the infectee's death.

HSV is, indeed, "self-limiting," so not technically progressive (unless you have an immunosuppressive condition, or the infection spreads to other areas, like your eyes or your partner's genitals, because you didn't know you you were contagious) but it is possible to help it self-limit with medication -- and avoid spreading it as well - if it is diagnosed properly and in time. I'm not debating whether the doctor made an honest mistake -- I suspect he did, and it's common and doctors make mistakes all the time because they are human and medicine is complex, and early HSV infection is easily misdiagnosed because it has a non-specific symptomology until the sores appear, as you well know. But while I am not a doctor, I have more than the usual level of lay familiarity with the lingo, and I don't think there is any "semantic" confusion over the use of "serious" in my remarks. "Progressive" has, indeed, a more technical sense than I meant, which certainly can and does apply to many viruses (aforementioned) -- so I assume you misspoke in dismissing the possibility that any virus could be progressive.

But certainly, within the course of an outbreak, HSV "progresses" from bad to worse before it gets "better", and the OP's case sounds like a brutal one that "progressed" to serious pain and suffering and intense anxiety and fear (also "progressive" conditions in a vernacular sense). Now, perhaps it's her fault for not going back to the clinic when the symptoms worsened (and were probably obvious). But the "progression" of her outbreak could have been ameliorated -- at least likely, anyway -- with a simple course of Valtrex. Instead, it sounds like she suffered quite horribly until she was diagnosed properly, and had scarring and other complications that she might have avoided. Serious, for her, surely. And progressive in a limited sense. Are we in agreement? The doctor's honest mistake caused her to suffer. Even an honest mistake is still a mistake.
posted by fourcheesemac at 12:49 AM on October 1, 2007

More precisely, I think the clinic nurse made the mistake here. If the OP reported the symptoms -- and especially the intense pain on urination -- she reports here in her follow up call and was seriously told "take a little codeine and wait for 10 days" there is a case right there for a fuckup. Any newly emergent serious pain should warrant a return visit.
posted by fourcheesemac at 12:51 AM on October 1, 2007

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