When someone comes to see you with a worry about their health, it helps if you can guess what they would like you to do. Often, they’re hoping that you’ll send them for a test. Or even several tests. By “tests”, people rarely mean the simple investigations you can do in clinic: blood sugar levels, oxygen saturations, a urine dipstick. These never seem to inspire as much confidence as X-rays or blood tests, or anything involving a consent form. While many people hate hospitals – anxiety, fuss, too hot, too busy – some greet the prospect of an X-ray with beaming relief. Nothing could be more popular – except for a CT scan. You can almost see people thinking: “At last – answers! Results!” There is no doubt medical investigations are potentially invaluable. So why are we always withholding them, a patient with backache asked me. Why not do some tests, if we have so many available?
當有人因為擔心自己的健康來找你的時候，如果你能猜出他們想讓你做什么，這通常會很有用。他們往往希望你讓他們去做一項檢查，甚至是好幾項檢查。就“檢查”而言，人們很少指的是簡單的臨床檢查：血糖水平，血氧飽和度和尿液試紙。它們帶給人的安全感似乎總也比不上拍X片、驗血、或是任何涉及同意書的檢查。盡管許多人痛恨醫院——這里充滿了焦慮與緊張，或是太熱，或是過于忙亂——但有些人認為，做X光檢查能令人放心。除了CT掃描，沒有什么檢查能比拍X片更受歡迎。你幾乎可以想象，人們會想：“終于——有了答案！有了結果！”毋庸置疑，醫學檢查的潛在作用不可低估。一位背痛患者曾經問我，我們為什么總是盡量不讓病人做檢查。既然有這么多可以做的檢查，為什么不去做一些呢？