Today’s word of the day, to continue the very brief medical-term trend, is idiopathic. It is one of my all-time favorite words. Idiopathic means “of unknown cause, as a disease” (https://www.dictionary.com/browse/idiopathic). Under “Origin,” the website says merely, “First recorded in 1660–70; idio- + -pathic (ibid.).

There is not an entry for idiopathic at www.etymonline.com. You have to look at idiopathy to get a sense of the etymology of the word. The etymology website says this: “’primary disease,’ 1690s, Modern Latin, from medical Greek idiopatheia, from idios ‘one’s own’ (see idiom) + –patheia, abstract noun formation from pathos ‘suffering, disease, feeling’ (from PIE root *kwent(h)- ‘to suffer’). Related: idiopathic  also from 1690s (https://www.etymonline.com/word/idiopathy#etymonline_v_34673).

So how do we go from “primary disease” to “disease of unknown origin”?

Under idio-, etymonline says, “word-forming element meaning ‘0one’s own, personal, distinct,’ from Greek idios ‘own, personal, private, one’s own’” (https://www.etymonline.com/search?q=idios). So we go from “one’s own disease” to “a disease of unknown origin” because the assumption in medicine is that a disease comes from somewhere else and infects a patient, but in this particular case, the person suffering from the disease is the primary or first place the disease, and therefore we do not know of an origin.

Here’s my story. My family had a black cocker spaniel years ago named Joey (yes, Joey Cocker Spaniel). Joey became very, very ill, so weak that he could not get down the three steps from our deck to our backyard. It came on very suddenly. Of course I took him to the vet. The diagnosis was, if I remember correctly, immune-mediated hemolytic anemia. This diagnosis followed on from blood tests and an x-ray which revealed a bloated spleen. Immune-mediated hemolytic anemia is usually fatal.

So with Joey lying on an exam table between us, I asked the vet, “What causes that?”

With a straight, serious face, the doctor said, “It’s idiopathic.”

I said, “Doc, I know what that means.”

And he laughed. Out loud.

Then he said, “In vet school, we used to say, ‘Idiopathic: the doctor’s an idiot and the patient is pathetic.’”

Because basically, when a doctor says that some medical condition is idiopathic, what he is saying is, “I don’t know.”

On this date in 2016, Julie Beck published, in The Atlantic, a book review of Snowball in a Blizzard: A Physician’s Notes on Uncertainty in Medicine. She wrote, “Doctors’ tools, knowledge, and treatments have improved since the bloodletting days, and we now have the ability to scan and analyze the body down to the cellular level. But ‘precision is not the same thing as certainty,’ Hatch writes, and often, doctors are just making guesses based on the best evidence they have—a measuring of risks and benefits and probabilities that can be easily influenced by their preconceptions” (https://www.theatlantic.com/health/archive/2016/02/when-doctors-should-say-i-dont-know/471222/).

The problem is that doctors rarely tell you that they really don’t know. Several years ago, my then-teenage son experienced extreme pain in his abdomen. He was in a nearby city, and his friend took him to the local hospital. The diagnosis? There was none. So I took to our local hospital, and he stayed three days. Upon admission, the doctors check him in a variety of ways. They said that the pain had nothing to do with his lungs, that it was probably lower down. After a couple of days of various doctors doing various tests, and of my son feeling better, a doctor came in and told us that they had finally decided that he had pneumonia. I tried to question him, since we were told initially that it had nothing to do with the lungs and that he had been lying in bed for three days in a hospital, and the doctor told me that I just needed to accept his diagnosis. We would have been much happier if the doctor had just admitted that after three days and multiple tests, they had no idea what had caused my son’s pain.

But it is not just doctors. It seems like it is experts in all kinds of fields. Here’s an interesting tidbit from Scientific American: “In a series of experiments published in July in Psychological Science, researchers at Cornell University tested people’s likelihood to overclaim in a variety of scenarios. In the first two experiments, participants rated how knowledgeable they believed themselves to be about a variety of topics, then rated how well they knew each of 15 terms, three of which were fake. The more knowledgeable people rated themselves to be on a particular topic, the more likely they were to claim knowledge of the fake terms in that field. In a third experiment, additional participants took the same tests, but half were warned that some terms would be fake. The warning reduced overclaiming in general but did not change the positive correlation between self-perceived knowledge and overclaiming.
“In a final experiment, the researchers manipulated participants’ self-perceived knowledge by giving one group a difficult geography quiz, one group an easy quiz and one group no quiz. Participants who took the easy quiz then rated themselves as knowing more about geography than did participants in the other groups and consequently were more likely to overclaim knowledge of fake terms on a subsequent test” (https://www.scientificamerican.com/article/you-don-t-know-as-much-as-you-think-false-expertise/).

The article’s conclusion was that if you think you know a lot about a subject, you might want to double check you knowledge.

I taught college kids for roughly 30 years, and it was one of the lessons that I had to learn. You have to learn to say, “I don’t know.” Now, it also helps if you add, “But I’m going to look into that, and I’ll get back to you. Please remind me of your question in our next class.” Then again, I could have coined a word for “I don’t know” that didn’t sound like I didn’t know. How about, idiogenic, a thing of its own origin.

The image today is from an online article in The Neuropathy Journal, “Is the Diagnosis of Idiopathic Neuropathy a Cop-Out?” The author says, “The second most common cause of peripheral neuropathy is ‘idiopathic’ (unknown cause).A cause which is not a cause is an oxymoron if ever I saw one” (https://neuropathyjournal.org/is-the-diagnosis-of-idiopathic-neuropathy-a-cop-out/).