I'm thinking that when physicians come up with names, and causes, and criteria for diseases perhaps we take them a little too seriously.  It is not, after all, as if they were describing the appearance of some creature standing right in front of them-a Dalmatian, for instance, or an aardvark.  It is not as if they invented the disease and accordingly know everything about it.  Rather, they are poking about in the murky waters in which the disease itself is wont to swim-its territory, not theirs.  They take a lot of pieces-hints and clues, a collage of suspicious parts-and arrive upon a presumption that seems fairly reliable. 

Multiple sclerosis, carcinoma, Parkinson's, cholelithiasis, cardiopulmonary disease.  The names themselves are convincing. 

When my brother was 29 he was diagnosed with sarcoma, a type of cancer.  He underwent chemotherapy and his primary oncologist determined that he had been cured.  A year later he died.  Something had gone wrong.  Was the diagnosis wrong?  Was the treatment wrong?  Perhaps he did not have a sarcoma.  Perhaps he did not have cancer.  The only sure thing is that he died, and he died from something that had gone wrong in his body.

How often have we heard the story of lengthy waits for a diagnosis of multiple sclerosis.  It starts out with the notion that it could be MS, then maybe it is something else.  Some things add up, some don't.  Some of us come out the other end of the MRI tube with a diagnosis of MS, some don't. 

In working for an ER and being exposed to the diagnostic methodology of physicians, I can tell you first hand that it is a process of guesswork and probabilities.  In every illness the physicians consider what they call a "differential," that being a list of things a particular set of symptoms "could be."  The list is often quite long.  Often enough, the etiology is judged "unknown," or at most merely "probable."

One thing is certain:  They did not look into the body with an x-ray and find a big red sign that said "Multiple Sclerosis."

By the same token, symptoms officially associated with one disease or another are really only a matter of percentages-things that turn up being common in most people said to have the disease.  We hear it said, therefore, and most often with unwarranted confidence, that this or the other symptom is MS, this or the other is not.

I wouldn't take that too seriously either.

For instance, since having MS I have suffered not only the common, "official" sort of symptoms-numbness and tingling, fatigue, cognitive difficulty, spasticity-but also the onset of symptoms supposedly not associated-a change in my vision that seems to have no ophthalmologic fix, a loss of appetite, dental pain.  I can't understand why the dentist refuses to pull the few teeth I have left and let me put in some of those dollar store chattering teeth.