Like many of you, every Monday morning I go to work. I am lucky enough to be able to retire like many of my colleagues. After all, I started to study Medicine in 1976 – fifty years ago! But what keeps me going is the extraordinary privilege I feel in being entrusted with the stories of my patients, in all their complexities, their struggles and their triumphs over adversity.

During the Covid lockdown, I decided to write a book about something that had been bothering me: so many of my patients had symptoms that were poorly understood and their resolution required a uniquely personal approach. 

This is the opposite of the usual medical problem: we doctors are trained in taking a history, doing a physical examination, a few tests and then working out the diagnosis. The treatment follows logically from the diagnosis. Pretty straightforward, once you know your medicine. 

However one in ten people live with what doctors call functional symptoms — real, sometimes debilitating experiences of pain, fatigue, weakness, or loss of function that elude conventional diagnosis. Up to one in three GP visits involve these very symptoms. Yet most people who experience them have never heard the term, let alone found a clear path forward.

As I researched both locally and internationally, I found a few other doctors and other health professionals who shared my interest in trying to formulate a way to help patients understand how these symptoms arise. 

I also talked with folks I knew through studying yoga and meditation (including, of course, the wonderful Timothea Goddard, who immediately understood what I was writing about). And gradually, I formulated a way to describe the means that lead to symptoms arising.

When I travelled to Germany, I found their doctors were way ahead of Australia and had a number of hospital units dedicated to treating people with functional symptoms (we have very few here in Australia). They have gone further and have started to develop guidelines for doctors to follow.

And here is the thing: doctors feel comfortable when we know our colleagues agree on the right treatment. Due to the unique and variable nature of functional conditions, they do not fall tidily into a model that doctors recognise. This is why you may have felt dismissed or not received treatment in the way you are used to with your physical condition. Doctors simply don’t know what to do. 

I am trying to bring some change to the training of doctors, but it is a very slow process, so instead, I focus on you directly, trying to get the message out that your symptoms are real, they are not your fault, and there are plenty of things we can do to help relieve them. 

The fact that you are reading this on the Openground website tells me that you are already on that journey and I want to reassure you that this doctor fully supports your efforts to learn about the mind-body interaction and means to influence it.

I look forward to meeting you on my webinar on the 11th July. https://openground.com.au/products/what-the-hell-is-wrong-with-me-workshop-live-online-11-july

Feel free to bring questions and we can help each other to a deeper understanding. 

Dr Gillian Deakin
MB BS MD MPH Dip FP FRACGP

—Dr Gillian Deakin