Given my post yesterday about how increased scanning finds more disease that may or may not ever cause problems (and, don't worry, the promised followup post is coming, either tomorrow or Thursday), I thought it was an opportune time to post this little gem that's been floating around medicine for a long time. I first got it back in the late 1990's, and there are several permutations of it around, all with the same basic message:
EVERYBODY MUST GET SCANNED
(Sung to the tune of Bob Dylan's "Everybody Must Get Stoned")
They scan you when you fall and bump your head
They scan you when they think you might be dead
They scan you when your pupils are unequal
They scan you when you've been beat by ugly people
They work as fast as they can
Everybody must get scanned
They scan you when your brains are in your ear
They scan you sometimes only out of fear
They scan you when you crack up your car
They scan you for anisocoria
They do it to help their fellow man
Everybody must get scanned
They scan you when you stop your respiration
To see if you're going to need an operation
They scan you to see what can be seen
They scan you to pay for the machine
There are better ways to get a tan
Everybody must get scanned
[HARMONICA SOLO, and continued after the fold]
They scan you when you decorticate
To see that you do not herniate
You know they scan all the old timers
To rule out Pick's and Alzheimer's
Alzheimer's
Glowin' in the dark is really grand
Everybody must get scanned
They scan you when your brain bites a bullet
They scan you for a shunt before they pull it
They scan you if you seize or have a spasm
They scan you to locate a neoplasm
It's the biggest microwave at The Lands
Everybody must get scanned
They scan you if you take a bad fall
They scan you for no reason at all
They scan you to look inside
And do it with Metrizamide
It's all part of the plan
Everybody must get scanned
I hope you have an education to fall back upon.
On the not-so-humorous side, I sometimes really wonder where the curve of increasing iatrogenic morbidity crosses the curve of prevented or cured disease. One increases and the other decreases with increased medical attention. I've seen enough of the former that I don't have the naive belief that some people seem to carry that increased medical attention is always a Good Thing.
On my more cynical days, I even wonder if the waits associated with some surgeries in the UK and Canada might not be partly responsible for the slightly longer lifespans there than here in the US. Keep those surgeons at bay for a few weeks, and some patients might decide they don't really need the surgery, and some of those won't die from surgical complications. Yeah, yeah, I know: a chance to cut is a chance to cure. And it is. But it's also a chance to get a hospital infection.
Sorry for being a little off topic. Tony Snow said before his latest operation that blood tests showed that the growth was not cancer. Any information on this test and why it was wrong. I have never heard of a general blood test for cancer.
patients might decide they don't really need the surgery, and some of those won't die from surgical complications
No; they'll die of their disease instead.
I sometimes really wonder where the curve of increasing iatrogenic morbidity crosses the curve of prevented or cured disease
Why do I sense a subtle attempt to troll here? You can't lump the whole of medicine together; you have to take each iatrogenic issue and compare it against the disease for which the treatment was intended. Let's do an experiment: let's totally block access to all conventional health care for twelve months - say, 1 Jan 2008 to 31 Dec 2008, and see how many people die or suffer serious illness.
Yeah, yeah, I know: a chance to cut is a chance to cure. And it is. But it's also a chance to get a hospital infection. As opposed to the infection they already have from their ruptured appendicitis or diverticulitis, or perforated ulcer or bowel carcinoma?
Your tendency to play up all the worst that can happen, and plant subtle seeds of doubt as to the safety and efficacy of the health system, makes you sound a great deal like an apologist for that field of quackery which is overtly hostile to conventional medicine.
Of course there are problems. But when you look at the number of iatrogenic incidents per year, you also have to look at the number of hospitalisations per year for which the natural history (disease left untreated) would be worse.
Justin, I was pondering where the two curves cross, and it clearly isn't at the end point of "no medical attention." I'm not an altie or someone who eschews modern medicine. There are circumstances where I've encouraged relatives to opt for more extensive surgery over more conservative surgery.
BTW, it's at the far end of maximal medical attention where medicine sometimes advances. But that's not necessarily the optimal point of medical care for the patients at the time, even though that of course is what each physician is trying to provide in each individual case. A bit of a tension there.
And for the other side of the debate:
http://youngsurvival.org/blocks/Forum/index.php?showtopic=11667
These are the thoughts of a group of young women with breast cancer about the issue of routine mammograms. The vast majority of them (us, I should say), were diagnosed with much later stage disease than our older counterparts because mammograms are not routinely given to women under 40. Are are willing to risk the lives of women like us because it's not "efficient" to screen the general population?
Laura, this is not as much a question of efficiency as lack of benefit in your age group and the higher potential to harm many women.
You should really read the earlier entry in this blog on the subject of early detection - the one referenced from this post.
Diora, I understand that, and I actually agree. I only posted the link to give a different perspective.
Also, keep in mind that many insurance companies REFUSE to give mammograms to women under 40 even if they have a strong family history of breast cancer. Can we at least agree that this is wrong, and that that population should get at mammograms if appropriate, and MRIs if not?
Laura
Laura - yes, I absolutely agree that insurance should pay for what is appropriate; sorry I didn't notice your post on the other thread earlier.
I strongly believe in women's right to decide what is right for them.