What happens when a diagnosis that has shaped someone’s life turns out to be wrong? Christina Applegate’s experience raises questions about medical certainty—and when to request a diagnostic reassessment.
Five years ago, American actor Christina Applegate was diagnosed with multiple sclerosis (MS) and later stepped away from on-screen acting. For years, the diagnosis explained her symptoms. She recently revealed that her physicians had misdiagnosed her condition. While those around her welcomed the news, she did not share their relief. She still struggles to walk, uses a wheelchair when necessary, and says her symptoms have worsened. Now she is searching for answers again.
Professor Shahar Shelly, director of the Department of Neurology at Rambam Health Care Campus and head of the Laboratory for Artificial Intelligence and Decision Making at the Technion’s Ruth & Bruce Rappaport Faculty of Medicine, says physicians must be willing to challenge their own conclusions.
“The medical community needs to show humility and recognize that we may be wrong,” he says. “We must welcome opportunities to reexamine diagnoses we once believed were correct.”
Diagnosing MS is especially challenging because no single test can confirm the disease. Instead, physicians consider the patient’s medical history and symptoms, perform a neurological examination, and review MRI scans of the brain or spinal cord. In some cases, they also analyze cerebrospinal fluid. Shelly explains that physicians assess evidence of central nervous system damage in multiple locations (dissemination in space) and, when needed, at different points in time (dissemination in time).
Reaching a diagnosis does not end the challenge. That diagnosis can shape how physicians interpret subsequent medical information.
Shelly explains that once physicians form an impression of a patient, it can be difficult to change. A diagnosis entered in the medical record may influence how subsequent findings are interpreted.
“MS tends to follow recognizable patterns, with distinct episodes or gradual progression. When a patient’s course falls outside those patterns, we need to investigate further,” Shelly says. He points out that a patient may deteriorate more quickly than expected, respond to treatments differently than anticipated, or experience worsening symptoms without corresponding changes on MRI scans. These discrepancies should be considered red flags, signaling the need to explore other explanations for the patient’s condition.
A misdiagnosis can expose patients to unnecessary treatment and delay the correct diagnosis and appropriate care. The condition causing the symptoms may remain undiagnosed, potentially narrowing the window for effective treatment.
A medical diagnosis can also reshape a person’s life and sense of identity. In the meanwhile, medical knowledge and research continue. He points out that a good physician will welcome a patient’s request for a reassessment of their diagnosis.
Patients also face psychological challenges and living with unexplained symptoms can leave one feeling isolated.
Patients need reassurance that the absence of a diagnosis does not invalidate their suffering. “What you feel is real. We do not doubt your symptoms, and we will continue to look for answers,” concludes Professor Shelly.
Based on an original Hebrew language article that first appeared on ynet
