Thursday, April 29, 2010

Alarms & excursions

In a recent interview Lord Winston said that ‘Far from making us bolder and stronger in the face of nature and its constant exigencies, medicine has made us more afraid. And nothing makes us more afraid than the medical profession’s current obsession with prevention rather than cure.’

It is indeed sometimes easy to lose both patience & respect for the medical profession. One day we are being told that we go to the doctor too often for minor complaints, the next we are being urged to let them examine us for something for which we have no symptoms & in all probability do not have.

The latest news is of a screening test for bowel cancer. It only takes 5 minutes, they say, though it is not clear from press reports whether that includes the time taken to remove any polyps that are found.

The test involves examination of the lower colon & rectum. It may take the doctor only 5 minutes but the patient will have to add to that the time taken to travel to & from the clinic & for waiting around. It will also presumably include the time taken beforehand when they have to stay close to the loo while the ritual cleansing takes place. Plus a small risk of damage from the procedure itself. Plus the emotional cost ranging from mild irritation to blind panic about what the procedure may find, plus the uncertainty about your future health even after the polyps are removed.

Well, bowel cancer is nasty, so perhaps it is all worth it. And it also prompts me to repeat this story from the blessed Minerva of the BMJ:

A 67 year old patient attended for colonoscopy as part of the national bowel cancer screening programme. He had what initially appeared to be an adenomatous polyp in the transverse colon. On closer inspection the object was shown to be an intact lecamidipine capsule. Simple washing removed it


MINERVA:J A H Harvey, V Hedley, and A P PoullisBMJ 2010;340:c128, doi: 10.1136/bmj.c128 (Published 19 January 2010)
Not surprisingly really, this item attracted the attention of the French medical profession:
Femme de 67 ans: coloscopie dans le cadre d'un programme de dépistage du cancer colique. On a pensé repérer un polype dans le colon transverse. Mais un examen plus attentif montre qu'il s'agit d'une capsule intacte de lecamidipine, éliminée par un simple lavage.
Presumably the fact that the drug was lecamidipine allowed the translator to identify the patient as une femme, but I have been unable to check that.

The Official Site of Professor Robert Winston

Related posts

Getting to the point of delivery

We are all sinners now