She was a middle aged woman. She came to our outpatient clinic, referred from a superspecialty clinic for pelvic pain and dysmenorrhea. The referring person had already prescribed an antibiotic and an NSAID. I checked her history and reports of various tests and procedures she had undergone before coming to us.
"You have undergone an MRI Scan?" I asked. She looked poor. MRI scans are costly.
"I came from the state insurance scheme hospital. They also performed an upper gastrointestinal scopy on me before performing the MRI scan. Then they sent me to GI medicine."
"Then what happened?" I asked her.
"They put an endoscope through my anus" she said. That was the proctosigmoidoscopy she had undergone.
"Then?"
"Then they sent me to GI surgery, from where I was referred to this clinic."
The GI surgeons were good. They had diagnosed the condition to be gynecological in origin, started the treatment we would have given, and sent her to us before any more endoscopes could be put in her by other people. I checked her up, and made a tentative diagnosis of pelvic endometriosis.
"Have you taken the medicines which were prescribed by the referring doctor?" I asked her.
"No. I am tired of taking medicines" she said. She should have been tired of getting endoscopes inserted through her natural orifices too, I thought.
"I will give you some medicines, considering there might me some pelvic infection. If they do not cure you, we will have to perform laparoscopy on you, an even perform some operation like cauterization of endometriotic spots and excision of endometriotic tissue" I said. then I explained what it was all about, and she went away.
"Poor woman" our Assistant Professor said.
"I agree" I said. It is surprising that someone would perform esophagogastroduodenoscopy and proctosigmoidoscopy and MRI on a woman who has pelvic pain and dysmenorrhea, and no GI symptoms. If we have to perform a laparoscopy on her, her total experience may be labelled as 'multiscoping' I wish she had come to us first."
"Sir, why would they do that?"
"It is probably tubular vision that specialists develop, being unable to see beyond their own specialty" I said.
