The word uncertainty is loaded with negative connotations. Or much in the way that American psychologist Virginia Satir would say, "People prefer the certainty of misery to the misery of uncertainty."
One reason the word uncertainty lands on my head is a mysterious patient of mine. A colleague of mine, and a nice guy who had attended the same high school as mine. He had been having a condition called FUO. To say your patient had a FUO is like saying you bumped into a UFO. Mysterious, yes, alarming, maybe, but never easy to settle. The name FUO may not ring any bells, but if you study medicine you know the acronym stands for "fever of unknown origin."
Physicians like me are indulged in solving the puzzle of FUO, but it's sometimes hard to crack the code. A caveat is warranted here: you simply have to unlock one bad thing after another, one by one, bit by bit. The FUO patient could have typhoid fever, malaria, cat scratch disease, cancer, AIDS, and all sorts of difficult-to-pronounce autoinflammatory diseases. The list of scans and of blood tests can be unbearably long. So much so that your patient might wonder if the weight loss can simply be a result of too much tests. When Jedidiah Jenkins suffered from FUO, he went to the hospital ten times and "had enough blood drawn to deflate a whale."
His doctor, like me, couldn't figure out what was wrong with him. I remember Jedidiah Jenkins quoting his doctor who said, "Believe it or not, this happens all the time. People get better, and we never find out what happened." For me, that captures what I believe I have to tell my patient. That's exactly where I am after tonnes of blood test, after removing a small piece of his kidney for examinaiton under a microscope, after ordering antibiotics and steroids.
It pains you to tell a patient you didn't find out what happened, but this happens. A lot.
