hat-591973_640 (1)I often have patients that see me with strange symptoms.  I listen…I examine…but the symptoms don’t fit into any of the pigeonholes of medical science, in fact, they often don’t make much sense at all.   They are real…in the sense that the patient is experiencing the symptoms, but there is no evidence that anything serious is causing what they are noting.

Could these be the first symptoms in an exotic condition that only Dr. House could diagnosis….sure?  But that is unlikely, and as I combine my training and 30 years of clinical experience in the practice of medicine, I will often conclude with the proper diagnosis:  Mishegas.

Mishegas is a yiddish term that means ‘crazyness’….something that does not make sense.   Now this is not to say that the patient is Meshuga (crazy themselves), but that the symptoms they describe do not fit into any known disease state and cannot be interpreted to suggest anything of seriousness.  It will come and go…without explanation.   There are so many cases of Mishegas that I could list thousands of cases in a year, because there is so much that we cannot specifically explain.   In fact, the amount of things we can explain in detail is somewhat limited, and doctors really enjoy those situations.  A straightforward appendicitis….is exciting.  Classic pneumonia….easy.   When the patient presents in a classic way, we can bring to bare all of our medical science, but when they provide symptoms that just don’t fit, and won’t ever fit, and don’t relate to anything serious…it’s another case of Mishegas.   And if you don’t like Mishegas as a diagnosis, I have another one that you might prefer…..Gornisht...but more about that later.