My most hated word in neurology

My most hated word in neurology has five letters: D-I-Z-Z-Y.

Very few words are as nonspecific, yet commonly used, as that one. And we hear it all the time. Patients say it. Other doctors (usually non-neurologists) use it. It’s on referral forms, admitting orders, and hospital face sheets.

It tells you nothing, and that’s what drives me nuts. Like any neurologist, I try to break it down. I used to say, "What do you mean by dizzy?" only to find that it led nowhere (beyond the response "You know, like ‘dizzy’"). Now I offer hints, though purists will accuse me of leading the witness.

Sorting it out can be easy or hard, depending on the patient. Is it vertigo? (It’s amazing to me how many other doctors use dizziness and vertigo interchangeably.) Lightheadedness? Imbalance? Or something else entirely? The most frustrating ones are where the patient says either it’s all of those or none of those. It’s even worse when the family is providing the history and just thinks the patient is dizzy, and the patient can’t reliably say.

Medical detective work can be fun, and these times are no exception if you can clarify things in a way that leads you to a reasonable diagnosis (or at least a work-up) and treatment. But not having a clear answer can result in unnecessary tests and medication trials, and will definitely delay finding the cause of the patient’s symptoms.

By nature, neurologists try to be precise. We want an exact diagnosis and a clear basis to rest it on. Words like "dizzy" are often maddening, frustrating, and hair thinning.

Just hearing it makes me dizzy.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

My most hated word in neurology has five letters: D-I-Z-Z-Y.

Very few words are as nonspecific, yet commonly used, as that one. And we hear it all the time. Patients say it. Other doctors (usually non-neurologists) use it. It’s on referral forms, admitting orders, and hospital face sheets.

It tells you nothing, and that’s what drives me nuts. Like any neurologist, I try to break it down. I used to say, "What do you mean by dizzy?" only to find that it led nowhere (beyond the response "You know, like ‘dizzy’"). Now I offer hints, though purists will accuse me of leading the witness.

Sorting it out can be easy or hard, depending on the patient. Is it vertigo? (It’s amazing to me how many other doctors use dizziness and vertigo interchangeably.) Lightheadedness? Imbalance? Or something else entirely? The most frustrating ones are where the patient says either it’s all of those or none of those. It’s even worse when the family is providing the history and just thinks the patient is dizzy, and the patient can’t reliably say.

Medical detective work can be fun, and these times are no exception if you can clarify things in a way that leads you to a reasonable diagnosis (or at least a work-up) and treatment. But not having a clear answer can result in unnecessary tests and medication trials, and will definitely delay finding the cause of the patient’s symptoms.

By nature, neurologists try to be precise. We want an exact diagnosis and a clear basis to rest it on. Words like "dizzy" are often maddening, frustrating, and hair thinning.

Just hearing it makes me dizzy.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

My most hated word in neurology has five letters: D-I-Z-Z-Y.

Very few words are as nonspecific, yet commonly used, as that one. And we hear it all the time. Patients say it. Other doctors (usually non-neurologists) use it. It’s on referral forms, admitting orders, and hospital face sheets.

It tells you nothing, and that’s what drives me nuts. Like any neurologist, I try to break it down. I used to say, "What do you mean by dizzy?" only to find that it led nowhere (beyond the response "You know, like ‘dizzy’"). Now I offer hints, though purists will accuse me of leading the witness.

Sorting it out can be easy or hard, depending on the patient. Is it vertigo? (It’s amazing to me how many other doctors use dizziness and vertigo interchangeably.) Lightheadedness? Imbalance? Or something else entirely? The most frustrating ones are where the patient says either it’s all of those or none of those. It’s even worse when the family is providing the history and just thinks the patient is dizzy, and the patient can’t reliably say.

Medical detective work can be fun, and these times are no exception if you can clarify things in a way that leads you to a reasonable diagnosis (or at least a work-up) and treatment. But not having a clear answer can result in unnecessary tests and medication trials, and will definitely delay finding the cause of the patient’s symptoms.

By nature, neurologists try to be precise. We want an exact diagnosis and a clear basis to rest it on. Words like "dizzy" are often maddening, frustrating, and hair thinning.

Just hearing it makes me dizzy.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.