Friday, August 14, 2015

Worrying the well

I have just watched an excellent and important programme on BBC TV (BBC2, 12 August 2015: Dr Michael Mosley: Are Health Tests Really a Good Idea?), which you can catch up with on BBC i-Player.  As its title indicates, it looked in depth at the value of some of the many tests well people undergo, and queried how far many of these were necessary.  Importantly, in view of the enormous costs of providing health care for an increasingly aging population, it asked whether the vast amount of money allocated to these tests, which are overwhelmingly directed at the still well, would better be spent on treating the already ill.  The conclusion by two very eminent physicians, one from the United States and the other from Britain, summed it all up beautifully.  Surely, they said, it is better to direct resources at where help is needed, which is when a condition has actually revealed itself, and not spend so much on recommending tests for the well whose results are often uncertain, if not downright misleading.  The case of mammograms, in particular, was examined here.  It was pointed out that they often lead to needless, harmful and unnecessary interventions (a figure of 9 out of 10 mis-diagnoses was given).

This is when I heard the very telling and hard-hitting phrase, which underlines exactly what I think is the wrong direction in which the machinery of health is heading, and that is that “we are worrying the well”.  Once we are given the slightest indication that there is a slight query about any test result, none of us will be able to forget this, and it will continue to haunt us.  As I said in my book, The Keepers of the Soul, “One of the many areas to be re-assessed is the Western reliance on statistics. The trouble with statistics is that they are illusory.  They appear to be based on scientific fact, and offer scientific validity, but they have no meaning whatsoever in the individual case.  If a test is said to offer a 60% probability of establishing that a person is likely to suffer a heart-attack, am I in the 60% category of the sick or in the 40% category of the well?  No-one can tell me this, but human nature being as it is, all 100% of us are unlikely to sleep easily at night with such a statistic hovering over our heads.  And yet we may never fall ill.”

And again, “Once in hospital hands, we often find they never let us go, for one test or another, imperfect as all tests must be, may surprisingly often yield a slightly ambiguous result which demands a different test or a further check-up later on, leaving us forever waiting for what we anticipate may be a dreaded result, as though shackled to a permanent pathological prognosis.  This is a depressingly frequent occurrence, for no doctor appears to dare sign us off for fear of future repercussions.”

I will leave it to the lovely British doctor in the programme to confirm what I so deeply believe in.  We are frightening well people”, she said.  And what I particularly liked was her conclusion.  “We are seeking technological solutions to existential solutions.  We all have to get old, we all have to die, we all have to lose people we love.  We are devoting resources to worrying the well”.   It is rare for anybody in what I call this medicalized society, particularly a medical practitioner, to state this so clearly and so baldly.  Modern society is in danger of adopting a mind-set which devotes too much time to searching for pathological symptoms instead of concentrating upon nurturing the valuable aspects of our life, and accepting the natural course of life, which may or may not include illness, but will inevitably conclude in death.



  1. I saw this programme too and was interested to see Dr Mosley's reaction to the potentially bad news arising from analysis of his DNA (testing for the likelihood of developing Alzheimer's, I think).
    Not everybody has the capacity to hear such information and know how to deal with it - Dr Mosley was visibly shaken on hearing his news.
    I agree that some doctors are reluctant to sign us off for fear of repercussions but I feel that patient expectation plays a huge role in this. Many sufferers of chronic conditions are unable or unwilling to accept that their symptoms may not have a medical origin, rather they may be a somatisation of an emotional response to a traumatic event. For some patients, it is a relief to have a diagnosis, however bad, in order to explain their symptoms. A lack of diagnosis leaves the patient in a state of limbo, of not knowing, but being told their symptoms are psychosomatic is for some just unacceptable. It infers a judgement, that these symptoms are all in the mind or are made up, when in fact they are very real and often debilitating. The cause may be emotional trauma buried deep in the subconscious and the symptoms are the body's only means of crying for help.
    This is where Five Element Acupuncture comes into its own - ID's and AE drains can start the process of allowing the patient to let go of past, negative emotions thus allowing the body to begin to self-heal.
    We are so lucky to have these skills at our disposal when Western Medicine sadly falls far short.

  2. Thank you for this very interesting comment, Jo. We are indeed lucky to have such profound ways of helping people cope with stress.