I think people have strange and exaggerated expectations.
You don't go to a car mechanic and expect them to have all the answers and perfect accuracy. The expectation is that they will take a look and provide their fallible opinion.
Reality is messy, and optimal care has a non-zero failure rate.
Listening is not an impossible standard.
Processing, weighing, and interpreting what patients say is a fundamental part of their job. Sifting through crappy data and figuring out what is relevant.
You are paying them for their personal biases.
The doctors interpretation:
“She’s clearly a drunk.”
Like I said elsewhere, a night in the hospital would have solved this immediately, but the doctor was unable to get past their own bias.
It's unclear if the doctors she saw even knew that Auto Brewery syndrome existed.
How many people have have gone to the doctor and lied about their alcohol use? 6 nines is 1 a million patients. There are probably more nines than that.
Auto mechanics frequently misdiagnose problems, especially those caused by electrical or software faults. But in the worst case they can usually just keep following the manufacturer's service manual and replacing parts in a trial-and-error process until the vehicle works again.
The human body is orders of magnitude more complex and there is no service manual. We have a few evidence-based medicine clinical practice guidelines but those cover only the simplest of cases. For anything more complex, physicians have to fall back on theory, intuition, and experience. It's not surprising that they sometimes get it wrong. And sometimes there's just no way to make a definitive diagnosis for the root cause of a patient's complaints and so treatment is necessarily symptomatic; this can be tough for patients to accept. I'm not trying to defend clinicians who make preventable errors or dismiss legitimate patient concerns but we need to be realistic about what is achievable given the current limited state of medical knowledge.
Listening is a simple standard. Doctors don’t listen because they don’t care further than getting more patients through the door faster.
If I tell my mechanic there is a problem with the steering, he’s not going to change the oil and send my car out, he’ll check the fucking steering.
If so, then the comparison is off. It isnt that the doctors "didn't listen", it is that they didn't correctly deduce a 1 in a million cause, based on the information they had.
Most doctors aren't interested in playing Detective for the extremely rare cause. They treat the most likely cause given the information that they have on hand
patients aren't saying "I have auto brewery and would like you to confirm it".
Patients are instead reporting symptoms which the doctor then has to interpret and find a likely cause. Even if they 100% believe the patients, the diagnosis may not be obvious. IF they dont 100% trust the patient, or think they may be confused, then it is even harder. Patients ARE very unreliable.
That's my whole point.
Why not make her do hand stands? Why not make make her wear pink?
You are picking a test because you know the disease.
Remember, it took several visits to figure this out, and no one even tried this simple thing to suss out if she was truly an alcoholic.
If they kept her at the hospital and took multiple BAC measurement, her BAC would be going down, making her look like a drunk.
The only way they would see BAC spike is if they loaded her up with carbs, which only makes sense to do if they already suspected auto-brewery.