Santiago's Syndrome - when doctors cannot diagnose what's wrong with a patient.

Dr Abe V Rotor

Let me quote a part of Santiago’s Syndrome, one of the short stories written by Dr. Arturo B. Rotor in his later years.

“Naku, you never saw so many doctors in your life,” he reported, “a hundred, maybe two hundred. Many were visitors from the V. Luna Hospital, the Veteran’s Memorial, Far Eastern, Santo Tomas, even from Pasig and Bulacan. All of them talking about me for two hours, my blood pressure, my favorite food, my bathroom habits. See this tiny lump under my arm? They stood in line just to feel that, men and women, professors and interns. Two hundred physicians, attending just one patient.”

But Berto, who occupied a bed just across him, muttered:

“That’s all very well, Tiago. But did they find out what medicine to give you to make you well again?”

“You don’t understand, Berto. First you have to identify a disease before you can treat it. My disease is so rare they have to study it some more. In that room this morning the doctors acted and spoke as if they had never seen anything like me. They don’t even have a name for it, so some professors got up there this morning and suggested that it be called Santiago’s Syndrome for the time being. xxx Long after I’m dead, many doctors will be using my name.”

The complexity of a disease remains. Man’s pursuit for cure and long life has been the preoccupation of our ancestors and it will continue on at an accelerated pace searching for cure and long life. This scene is typical in a modern hospital, and to a typical patient like Santiago, it is one too unfamiliar, too scientific, he could not fathom with his simple thoughts and background.

If we compare this scene with one happening in a remote village, the patient, though equally unfamiliar where people relies mainly on alternative medicine, the original people medicine. the herbolario attends to a patient in the likes of Santiago. It could as well end up with the same syndrome – only in a different name. Maybe associated with a spirit or a wrongdoing in sacred place,

More and more people are recognizing the importance of environmental medicine, alternative medicine and conventional medicine.

In simplistic terms, conventional medicine targets specific ailments as they are properly diagnosed; alternative medicine makes good use of age-old and homegrown remedies - practical and familial; while environmental medicine strives to maintain a natural environment free or reduced of the cause of ailments. From a planner’s point of view the sequence is in this order, inasmuch as creating a healthy environment is primordial, alternative is tradition- and community-based, and conventional is science- and technology-conscious.

Thus the treatment of allergy has been split separately into these camps, with environmental medicine taking the center stage, apparently in response to problems generated by the unabated degradation of the environment. But like conventional allergists, environmental-medicine doctors recognize allergy as an abnormal response to substances that our system recognizes as foreign instead of familial, only that the inclusion of other factors wider in scope and consequences, affecting more than the respiratory tract, the gastrointestinal system, and skin, but whose symptoms include every organ of the body – including the brain, bladder, and reproductive organs – while masquerading as other diseases. Environmental allergists believe that allergy and “environmental illness” are often one and the same. ~

Dr. Arturo B. Rotor Memorial Lecture
11th Biennial Convention, September 6, 2008
Philippine Society of Allergy, Asthma and Immunology