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“Wherever the art of medicine is loved, there is also a love of humanity.”Hippocrates

I saw a good friend of mine who values his life so much that he thinks he needs to go for all blood tests every six months. He was there yesterday and was all anxious with a thick file of 14 bond paper sheets with all kinds of reports!

It took me a good half an hour of time to read through them : one full page for blood fats alone when the USA has removed cholesterol from the bad boy list for diseases in America. The lab technician suggested that his cholesterol was sitting on the fence and needs to be brought down immediately with statins lest it should kill him of a heart attack soon! Who will not worry under such threats? The man was shaken. He was also told that he has a thyroid problem in addition just because his isolated TSH report was high while his T3 and T4 levels (thyroid hormone levels) were well within the normal range. His sugars were normal in spite of his being a known diabetic. IF this is not corporate monstrosity what is?

The reader should understand that a human being must first see his family doctor even with minor abnormal symptoms but not when he is fine and healthy. A well-trained doctor should give him a complete physical check-up which is both helpful for the diagnosis and does act as a placebo therapy in addition. His blood tests should be done limited either for confirming or refuting that clinical diagnosis. This is healthy medical practice and is the best for the common man.

Getting all available blood tests first and then going for clinical examination under great stress could be dangerous. Thank God, it takes lots of efforts to allay report-oriented anxiety from lay people’s minds.

Some reports could even be fatal. Look at this strange case reported by an US doctor. A man went for a complete check-up and had his chest x-ray included in that. The latter showed a funny coin lesion in the right lower lobe.   Though the man was healthy,  American standard of defensive medicine warranted further tests on the coin lesion. The lung biopsy resulted in a massive pneumo-thorax and the patient almost died but the heroic doctor could extricate him from the jaws of death. The man survived by the skin of his teeth. He could have died because of the defensive medicine in the US!

The biopsy report proved it is a benign lesion but the last line in the typed biopsy report read that there were a few cells on the border line showing strange nuclei. The internet-savvy patient presumed that it could also be malignant. To the doctor’s dismay this patient died in the next six months of advanced cancer lung! The confused doctor wanted to go deep and went home to the family of the dead man only to find that he had a MMR (Mass Miniature Radiography) before he got his job in the Ford factory in the 1950s when TB was rampant there. Interestingly, the MMR did have the same coin lesion which was discounted by the factory doctor. The patient was not told about it. The man lived happily with the lesion for forty years with the lesion inside, unbeknownst to his mind,  but was killed in six months when he thought it could be cancer! That is the power of the human mind so well documented by Dr. Joseph Murphy in his classic The Power Of Your Subconscious Mind published by POCKET books, New York, one of the most powerful self-help guides ever written.

Coronary Angiograms

Another area of the killer-anxiety generated by the corporates is the Coronary Angiograms showing blocks ranging from 5 to 100 per cent! This could be seen even in healthy children in their teens. They do it to generate revenue for running such money-spinners called hospitals but tell the hapless patient that it is the gold standard for making a diagnosis of coronary artery disease which is miles away from isolated coronary artery blocks which nature effectively bypasses from the start with plenty of collaterals! The latter fact is neither known nor ever informed to the patient to keep our till moving. I can still vividly remember the words of a great cardiology teacher in London, John Mitchell, foundation professor of medicine, way back in 1972 in a meeting on recent advance in diagnosis of coronary artery disease when angiograms were making big time entry. He summed up his take home message after three days of grilling was loud and clear. He said: that coronary artery pictures were not the gold standard for diagnosis of coronary artery disease, (he called that as ischaemic myocardial pain) and emphasised the need to do a thorough bedside examination to arrive at its diagnosis aided and abetted rarely by tests which holds good even today. The only test that might help confirm the diagnosis is the thallium scan of the myocardium when needed as it also could tell us about its reversibility of the lesion with interventions.

So why are coronary angiograms done left, right, and centre in hospitals these days? This is another glaring example of corporate monstrosity to “make money in the sick room” out of human misery. Scientific indication for an angiogram is only when a bedside diagnosis of coronary artery disease is made on the bedside and it is decided that bypass surgery might help the patient (under two indications only: intractable chest pain not relieved by any means and/or very poor ejection fraction (EF) where the patient becomes breathless even at the slightest effort) only to get anatomical guidance for further plumbing and nothing else.)

Bypass surgery does NOT prolong life, nor guarantee from another heart attack or any other benefit;  but it can increase the risk of second heart attack by double,  and quadruple the risk of a major stroke, increase the chance of sudden death syndrome and create major or minor cognitive damage post-operatively. So those who are sending me angiograms for management advice should note that it is NOT done on the angiogram but on the patient’s need. If you want free consultation please send your patient by email and NOT the reports and angiograms wasting my time and peace of mind!

So please remember the golden rule in scientific practice of clinical medicine is diagnosis, second diagnosis and finally also bed side diagnosis. Tests are only to confirm or refute the clinical impression.

“Share your smile with the world. It’s a symbol of friendship and peace.” Christie Brinkley

(Belle Monappa Hegde often abbreviated as B. M. Hegde (born 18 August 1938) is an Indian medical scientist, educationist and author. He is a retired Vice Chancellor of the Manipal University and the head of the Mangalore Chapter of Bharatiya Vidya Bhavan. He has authored several books on medical practice and ethics. He was Professor of Cardiology [Visiting] London University since 1982. He was Emeritus International Advisor to The Royal College of Physicians of London and Edinburgh. He was First Indian examiner for MRCP [UK] examination in the UK from 1988 to 1998. He was MRCPI examiner in Dublin since 2000 till 2009. He served as President of World Academy of Authentic Healing Sciences, Mangalore. He has been a Non Executive & Independent Director of Zydus Wellness Limited since July 29, 2009. Dr. Hegde has 47 years of teaching experience to undergraduates and postgraduates. He has been a professor of Medicine since 1973. Dr. Hegde, an elected fellow of the National Academy of Medical Sciences, has won Dr. B. C. Roy National Award in the category of an Eminent Medical Teacher, Dr. J. C. Bose Award for Life Sciences Research, PRIDE OF INDIA Award from the Pacific Association of Indians in California and many more. Dr. Hegde is Padma Bhushan awardee 2010. He is MBBS, Ph. D. [Hon. Causa], MD, FRCP [London], FRCP [Edinburgh], FRCP [Glasgow], FRCPI [Dublin], FACC [USA] and FAMS[10]He is also the Editor in Chief of the medical journal, Journal of the Science of Healing Outcomes. He was awarded the Dr. B. C. Roy Award in 1999. In 2010 He was honoured with a Padma Bhushan, one of India’s highest civilian awards. Hegde is visiting faculty at many universities.

E-mail : hegdebm@gmail.com)

 

See also

https://www.countercurrents.org/hegde190416.htm

https://countercurrents.org/…/counter-thinking-bp-what-is-normal-blood- pressure/

https://countercurrents.org/2016/09/29/interventional-cardiology/

 

 

 

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