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?
当有人因为担心自己的健康来找你的时候，如果你能猜出他们想让你做什么，这通常会很有用。他们往往希望你让他们去做一项检查，甚至是好几项检查。就“检查”而言，人们很少指的是简单的临床检查：血糖水平，血氧饱和度和尿液试纸。它们带给人的安全感似乎总也比不上拍X片、验血、或是任何涉及同意书的检查。尽管许多人痛恨医院——这里充满了焦虑与紧张，或是太热，或是过于忙乱——但有些人认为，做X光检查能令人放心。除了CT扫描，没有什么检查能比拍X片更受欢迎。你几乎可以想象，人们会想：“终于——有了答案！有了结果！”毋庸置疑，医学检查的潜在作用不可低估。一位背痛患者曾经问我，我们为什么总是尽量不让病人做检查。既然有这么多可以做的检查，为什么不去做一些呢？