Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

Dr. Jon LaPook Interviews Hypochondriac, Susie Essman

Susie Essman, aka Susie Greene of Larry David’s HBO program, “Curb Your Enthusiasm,” has written a hilarious book (and yes, I actually read it) called What Would Susie Say?: Bullsh*t Wisdom About Love, Life and Comedy. For this week’s CBS Doc Dot Com, I talked to Susie about some of her health issues covered in the book, including menopause, fear of germs, and hypochondria. “So far this month,” she told me, “I’ve had Lyme disease, hysterical blindness, enlarged prostate….”

If any woman could actually have an enlarged prostate – either her own or snatched in a fit of pique from her beleaguered television husband played by Jeff Garlin – it would be Susie Green. But as we discussed her real and imagined symptoms, it became clear that Susie Essman can be easily talked down from her flashes of hypochondriacal thinking. So she doesn’t actually meet the official psychiatric definition of “hypochondriasis,” in which a misinterpretation of symptoms leads to a preoccupation with having a serious illness that interferes with daily functions and lasts at least six months despite reassurances from a doctor. In fact, her belief that she’s a hypochondriac is hypochondriacal.

True hypochondriasis can be a devastating illness but fortunately affects only about three percent of the population.

Many more of us – just like Susie – have occasional hypochondriacal thoughts that can be extremely challenging for doctors to address. As a physician, I do fear missing a serious illness in somebody who happens to be hypochondriacal. For me, the best approach has been to take complaints seriously, do a complete history and physical, and allow plenty of time for discussion. A patient who is convinced his day-old headache is from a brain tumor is not going to be reassured by “Oh, it’s probably nothing” over the phone, especially if his friend just died of a cancer that was initially misdiagnosed. We’ll both be relieved after his exam is normal and a conversation reveals he’s been under extreme stress at work and, by the way, stopped drinking coffee two days ago.

If symptoms persist I can always pursue further evaluation later. Spending adequate time with patients is the best way to avoid unnecessary and expensive testing such as MRI’s and CT scans, about a third of which are unnecessary.

Fortunately, my years of training and clinical experience have completely immunized me against hypochondriacal thinking. And I plan to set Susie straight about her prostate as soon as the pain from my ovarian cyst resolves.

Click here to watch Susie Essman discuss hypochondria, menopause, fear of germs, the teenage brain, intimacy in her marriage, the difference between men and women, what to look for in a man, and why she likes growing older. The clip ends with a very touching description of her grandmother Millie, who she adored.


You may also like these posts

Read comments »


One Response to “Dr. Jon LaPook Interviews Hypochondriac, Susie Essman”

  1. deepa says:

    A valuable information

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »