Monday, March 19, 2012

Random Medical Facts

     In the following, when I state a "fact", I am referring to a datum that has been verified in at least one double-blind clinical study. If I say there is "no evidence", I mean that there has been no such study. And I want to remind my readers that, as always, statistical correlation between condition or action A and disease B does NOT mean that A causes B----I refer you to Hume's "A Discourse Concerning  Human Understanding" for a further discussion of this as well as  the pitfalls inherent in reasoning by induction. Finally, absence of proof is not proof of absence, in that even though there may be no evidence that an intervention saves lives, the intervention may save lives nevertheless.

1) There is no evidence that an annual physical saves lives.

2) We do not know how often a patient should be brought back for evaluation for ANY condition, i.e. the optimum time interval to preserve the patient's health. We choose a time interval that "feels" right for pap smears,for blood sugar tests, for blood pressure checks, and the like.

3) A doctor seeing a patient with a physical complaint should always ask him/herself two questions: (a) is this patient ill enough to need hospitalization, and (b) what disease could the patient have that could kill him/her if I don't make the diagnosis and start treatment.

4) There is no evidence that total body CT scans saves lives.

5) There is no evidence that fast electron CT scans to evaluate cardiac calcium saves lives.

6) With the exception of a single abdominal ultrasound in males over the age of 65 who have hypertension there is no evidence that screening ultrasound Doppler studies of arterial flows saves lives.

7) Copper wrist bracelets do not treat/prevent arthritis.

8) A staple in your earlobe does not help you to lose weight.

9) The only guaranteed weight loss treatment, which also can reverse diabetes and bring the patient back to normoglycemia is stomach banding.

10) Every patient understates to the doctor the amount of cigarettes and alcohol consumed.

11) Virtually every patient has had or will have "unsafe sex".

12) Eight glasses of water or other fluid a day is not necessary for good health.

13) If you have a purely vegetarian diet with no vitamin supplements you will die from pernicious anemia.

14) All cigarette smokers will develop chronic emphysema and end their lives attached to an oxygen tank if they live long enough.

15) If you want to be tested for Sexually Transmitted Diseases, donate a unit of blood to the Red Cross or your hospital blood bank. Not only will they test your blood free of charge, there will also be no note or record of the test being done in your doctor's medical chart, and you will have helped your country.

16) Pregnant women have the keenest sense of smell of all. When a pregnant woman calls the gas company to say that she smells a gas leak, the repairman never leaves the house until the leak is found.

17) We don't know why some people sneeze uncontrollably when they leave a dark movie house in midday and their eyes are struck by the full force of the sun.

18) Please, please, please never look up your symptoms on the internet. EVERY complaint will be listed as possibly being due to AIDS or cancer, and usually Alzheimer's Disease as well. Please wait until you are given a diagnosis, and then look the diagnosis up.

19) One-half to one drink of any alcohol---beer, wine, whiskey--reduces the heart attack rate and increases your life span.

20) Coffee increases mental alertness, shortens eye-hand reaction time, reduces depression, treats asthma, and potentiates all pain medicines.


  1. these are cool except #15.
    VERY bad idea to encourage people who want to be tested for std's to do so by donating blood.
    This increases the risk of contaminating the blood supply as the pretest probability of this group (ie people wanting to be tested for std's)actually having an std is higher than the general population, decreasing the negative predictive value of the test.

  2. I should have made it clear that the people I encourage to donate blood in lieu of STD testing are those whom their soon-to-be-lover insists get tested, but not if I or they have any suspicion of true risk.

  3. as always your column is superb...and this is from another doctor/writer!!