I once saw a 5 or 6-year-old patient whose eyebrows were “falling out”. Her mother told me that she had brought her daughter to see a variety of doctors- GPs, endocrinologists, etc.- but none of them could figure out why the hair on her eyebrows were disappearing.
After talking to the young patient, asking her mother about family history, life at home, life at school, etc. and examining her sparse eyebrows, I told the mother that the diagnosis was trichotillomania, i.e. the girl was pulling out her eyebrows herself, as a coping mechanism to deal with negative emotions such as stress, anxiety and tension (mainly at home, in her case).
The mother’s reaction was shock and denial. She had spent all this time seeing so many doctors who ran so many tests but couldn’t find out what was wrong with her daughter, and here I was telling her that her daughter was doing this to herself. She just couldn’t believe it. I told her to observe her daughter (from a distance) for one week. If my assessment was right, they could come back to see me in a week’s time for treatment. If my assessment was wrong, they didn’t need to come back.
The mother came back with her daughter to see me in a week’s time and confirmed what I had suspected.
Things aren’t what they seem sometimes. When “stuck” in a situation, we often need to think outside the box to figure out what’s really happening. I guess that goes for health ailments as well as everything else in life.