What I Learned as Both a Patient and a Clinician
Guest post by Cherika Gadson, FNP-C, vestibular patient
Dizziness is one of the most common symptoms encountered in healthcare. It is also one of the most misunderstood.
As clinicians, we often hear words like dizziness and vertigo and quickly begin forming a differential diagnosis. As patients, many use these same words to describe what they are feeling, often without realizing how broad those terms are.
For a long time, I approached dizziness the same way. Until I experienced it myself.
Living with vestibular migraine changed how I listen because I realized something I had previously overlooked: Not all dizziness, and not even all vertigo, feels the same to the person experiencing it.
The Language We Share, But Don’t Define
In both clinical and everyday settings, patients often use the words dizziness and vertigo interchangeably. But those words can represent very different experiences.
When patients say they feel dizzy, they may mean:
- The room feels like it is spinning
- They feel like they are moving while standing still
- They feel lightheaded, like they might pass out
- They feel off but cannot clearly describe it
To a clinician, these differences may seem subtle. To a patient, they are not. And when those distinctions are not explored, important details can be missed.
The Question That Changed My Approach
Through my own experience, one question has become central to how I assess dizziness:
Does it feel like the room is spinning, or does it feel like you are moving?
That question alone does not make the diagnosis. But it changes the conversation. because it shifts us from assuming what a patient means to understanding what they are actually experiencing. More often than not, patients do not volunteer that level of detail unless they are asked.
Why This Matters
Dizziness is not a diagnosis; it is a symptom. And how that symptom is experienced can help guide the differential diagnosis, the next set of questions, and the overall plan of care.
It does not replace a full clinical evaluation, nor does it rule out serious conditions such as cardiovascular or neurologic causes. But it adds clarity.
Research has shown that dizziness can represent multiple underlying mechanisms and that patient-reported descriptions can provide meaningful clinical direction when explored carefully. (Drachman & Hart, 1972; Newman-Toker & Edlow, 2015)
Bridging the Gap Between Patient and Provider
As a clinician, I was trained to categorize symptoms efficiently. As a patient, I learned that not every symptom fits neatly into a category. That experience taught me to slow down and ask more specific questions.
For clinicians:
- Do not rely on the word dizziness alone
- Ask patients to describe what they feel in their own words
- Clarify the quality of the sensation before moving forward
For patients:
- Try to describe what the sensation feels like, even if it is difficult
- Use comparisons or examples when possible
- Understand that your description helps guide your care
A Shift in Perspective
Before my own experience, I approached dizziness as something to categorize quickly. Now, I see it as something that requires more careful listening, because sometimes the difference between “the room is spinning” and “I feel like I am moving” is not just descriptive, it is clinically meaningful. And just as importantly, it is validating.
Closing Reflection
Vestibular conditions are often invisible. But the way patients experience them is not.
When we take the time to clarify what someone truly means when they say “I feel dizzy,” we do more than improve diagnostic accuracy; we create space for understanding. And in conditions where patients often feel misunderstood, that can be just as important as the diagnosis itself.
References
- Drachman, D. A., & Hart, C. W. (1972). An approach to the dizzy patient. Neurology, 22(4), 323–334.
- Newman-Toker, D. E., & Edlow, J. A. (2015). TiTrATE: A novel approach to diagnosing acute dizziness. Neurologic Clinics, 33(3), 577–599.
