diagnosis

It's tempting to complain that Americans today are wussy hypochondriacs, overmedicated and overtreated for all kinds of imagined disorders. Some of them no doubt are. But, to take my personal experience as an example, many aren't.

As a child, I coughed myself to sleep for years and slept with my head up on two pillows; today, it's clear I have allergic asthma. Growing up in New Jersey in the 1970s, I saw that all Indian grandmothers, like generations before them, stooped over from what we'd now call osteoporosis. For years, as a child, my wife suffered from chronic fatigue, later diagnosed as autoimmune hypothyroidism; when she was later anemic for more than a decade, an astute physician realized she has celiac disease. When my older son's speech was mildly delayed, some of my older relatives dismissed it as nothing; he later failed routine development screening, got formal speech therapy from the state, and normalized. A former radiologist who became forgetful, my father-in-law was told he was developing Alzheimer's disease. After he died, I requested an autopsy of his brain and was startled to get a call from federal lab concluding he had Creutzfeldt–Jakob condition, possibly a variant of mad cow disease. When my younger toddler developed chronic belly pain and weight loss, he was tested for celiac disease, lead poisoning, and other unusual conditions; he was soon diagnosed with severe, chronic constipation likely related to milk intolerance (present in 2 percent of toddlers), which improved drastically with proper laxative use.

- Should we blame overdiagnosis for rising healthcare costs?