A Malady Without a Name

By Dr. April Anderson, MD, chief medical officer, Premier Physician Network

In 1927 when Dr. Francis Peabody ended his famous essay, “The Care of the Patient”, with the words, “One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient,” he was already suffering from a leiomyosarcoma of the stomach which ended his life later that year. Almost 100 years later, Dr. Peabody’s essay is as timely today as the day it was written. He discusses the care of patients whose symptoms have taken them on a journey to the edges of medical science and who still have not found answers, an all-too-common scenario in our modern hospitals and offices. 

What can be done for someone suffering from a malady without a name? A person with, as Dr. Peabody describes, “symptoms that cannot be accounted for by organic disease”. Often this person’s symptoms are the source of anxiety and fear, subjecting them to repeated tests and investigations which leave them exhausted and frustrated.

An important element to remember is the human relationship between the clinical staff and the patient in this scenario, described elegantly by Dr. Peabody. He suggests that providers take some lessons from nurses in how to make patients more comfortable, and that by doing these things, the dynamic will shift and allow the patient to “unburden himself”

Accepting the privilege of caring for a patient and allowing that person to share important details will help transform the relationship from one where the team treats “a gastric ulcer” to one where they treat “John Smith, who happens to have a gastric ulcer.” Disclosures about Mr. Smith’s life can make or break his treatment plan, especially if he is withholding a stressful life event, like a divorce or the death of a loved one.

Acknowledging the limitations of our current state is another important reality when caring for someone with unexplained symptoms. We may not know the precise reason why the symptoms are present, but we can believe the information we are being told about the symptoms and the impact they have on a person’s life.

Premier Health’s commitments of presence and understanding are a testament to the validity of Dr. Peabody’s essay.  He served his patients with compassion and respect until the very end of his life. 

Back to the September 2025 issue of Premier Pulse