Getting Sick: Iatrogenic Woes

February 1971

A junior in high school living and learning at a boarding school in Austin, she enjoyed the occasional free weekend in Houston with her sister, her husband and their two young daughters.This trip started out like all the others. A happy reunion with family, a different routine, freedom from tasteless school cafeteria food.  She remembers eating Fulshear sausage dripping in barbeque sauce, maybe too much but it tasted so good.  A freshly made bed waited upstairs. If her real home was thousands of miles beyond, this had to be second best.

No one would have expected that she'd not make it back to school for class on Tuesday. No one would have predicted she'd get sick enough to be popped in the hospital with a nasogastric tube and IV fluids to decompress a hugely distended stomach and guts which simply quit working for over a week. No one would have expected she'd be out for the better part of the trimester, leaving the hospital to recover in Aruba and then back to school in late March.

I know that what happened to me was iatrogenic.  When all that rich food and a possible overlay of irritable bowel syndrome or norovirus infection gave me the belly gripes, I was able to get a Saturday appointment with my sister's internist. I remember getting an injection which would "relax your belly" which was apparently in knots. In retrospect, this was not a good move on his part.

I don't blame the doctor. The problem is my unique and unpredictable patho-physiology, an unusual, amplified reaction to a medication designed to relax the gut and offer relief of symptoms. In my case, the drug paralyzed my entire GI tract. I know very well that patients don't come to us with an instruction manual about which drugs may have a paradoxical, harmful reaction in their system.

I put together my theory about a drug causing my gut woes and hospitalization only after having a similar experience years later, during my thrid trimester of pregnancy with Laura. I self medicated my abdominal discomfort and bloating with an anti-motility drug and paid the price. A drug that should have helped me backfired so badly that I wound up in the hospital for three days until my insides started working again. Paralysis.

I used to think that the term iatrogenic meant that the doctor made a mistake in the care of his or her patient. Not so. Iatrogenesis plagues all physicians. We deal with human physiology which presents without an accurate road map. We do the best we can. I doubt any of us intends to cause harm.