Multiple studies also demonstrate that patients with chronic pain are more likely to suffer from a mood disorder. This left Atul with the conclusion that Rowland’s pain was a “mental” pain. That would be very common, especially for workers, but what perplexed Gawande is that no one understood the origin of the pain, until one day Rowland’s wife noticed that the pain would always start when Rowland was in a bad mood and would stop immediately once he got into a better mood. Rowland Scott Quinlan, an architect, suffered from severe back pain. In the book, Atul mentioned two examples of this. One would assume that chronic pain is due to a problem in the patient’s bones or muscles because that would be a logical assumption and it was what most physicians assumed, but it turns out that that’s not always the case. The second medical issue that I choose to write about is the mental impact on chronic back pain or any physical pain in general.

What’s also interesting to note is that Rumination syndrome has been associated with anxiety, depression, obsessive compulsive disorder, and post-traumatic stress disorder (UpToDate, 2018). Physicians are still not sure why Rumination even happens in the first place but fortunately, there’s almost never physical damage, and rarely can cause problems with the esophagus. It’s important to keep in mind that rumination is not a conscious decision, but rather a reflex of the body. While vomiting happens usually when you have consumed something your body is not used to, Rumination happens all the time, each day, regardless of what you ate and generally occurs in children and infants. With Rumination, the food is still undigested and still tastes the same as when it was first eaten.

While telling us about the possibilities that made the woman nauseous, he recalled a childhood classmate who would vomit at “will” without feeling sick and that would eventually introduce our topic Rumination.

In the book, Gawande was telling us the story of a pregnant woman who would constantly feel severely nauseous despite the fact that she was no longer during her first trimester, which is usually when women get their morning sickness. Rumination syndrome is the first intriguing medical issue. Due to this book being a book of flaws, there are a lot of medical issues that were discussed in which I’ll write about two of them.

Complications by Atul Gawande