Dear Eric: This is in reference to “Caring Friend.” As a physician, I disagree with your advice to the writer with a friend experiencing intermittent blindness who will not get medical care because they experience claustrophobia in MRIs. Either way, this will not end well for the writer. If the friend dies, the writer will feel long-lasting guilt for not pushing harder. If the friend suffers further damage, the writer will be blamed for not being a stronger friend.
The writer needs to send the friend a note (or, better yet, an email so that there is a record) saying that they will no longer be in contact unless the friend sees a physician.
Physicians face this type of dilemma every day. Patients don’t take our advice yet blame us for the consequences. We are used to this (though still affected by it) but, at least, we have detailed records to support our advice.
— Reader
Dear Reader: If the letter writer severs the relationship with their friend, who is clearly experiencing some medical trauma and anxiety, and the friend dies or gets worse, having a written record of their separation is going to be a cold comfort. There are other solutions, both medical and personal.
Dear Eric: I am an anesthesiologist in Boston. While not the point of the letter from “Caring Friend,” I wanted to let the writer know that MRIs can be done with sedation for patients with indications (i.e., claustrophobia, pain causing an inability to lie still or flat, delirium/dementia, etc.). I did one today with sedation. It is definitely more common at bigger institutions but should be an option at almost any hospital that has an MRI machine and an anesthesiologist. They may not want the MRI for fear of the diagnosis or some other reason as opposed to the claustrophobia, but this option does exist.
Best of luck to this person.
— Another Option
Dear Another Option: Thanks for writing. Many readers responded to this letter with stories of their positive experiences with open MRIs—as was suggested in the column—or sedation, as you’ve recommended here. I hope the letter writer will feel empowered to help the friend explore other avenues for medical care as they seek answers to their troubling symptoms.
(Send questions to R. Eric Thomas at eric@askingeric.com or P.O. Box 22474, Philadelphia, PA 19110. Follow him on Instagram and sign up for his weekly newsletter at rericthomas.com.)
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