The Danger of Investigations

The Danger of Investigations

As a doctor I would sometimes ask a patient whether it was more important that they could be told what was wrong with them, or whether it could be fixed without ever knowing this. Surprisingly – maybe – most people choose the former option.

Medicine has become increasingly – even exclusively – scientific. We have come to believe a medical diagnosis is an objective reality, such that pathology and other investigations are relied upon for “knowing what is wrong with you”.

But is this actually the case, or is it leading people – doctors and patients both – down a slippery slope of reliance on investigative institutions with names that often include “pathology” and “diagnostic”, as if the two are synonymous.

Illness need not be pathological; in fact, it generally isn’t. This is maybe why you have heard the catchphrase from your doctor that there is “nothing wrong with you”, when tests come back as normal.

Nor are investigative procedures including blood tests and radiology diagnostic; they provide information and should support a diagnosis, they do not define it.

At medical school I was taught that you should have a diagnosis by the time you have finished talking to a patient; that is, heard their story. The physical examination is to confirm or deny this, and investigations extend further on this process and add quantitative information.

When someone consults a doctor they are suffering. This suffering is not in the blood or at the end of a CT scan. It is in “you”, the person, the soul. It comes with a background – a history – and is woven into a story.

As Sir William Osler the so-called founder of modern medicine said, if you let the patient talk long enough they will tell you what is wrong with them. We have lost touch with this core principle.

Someone who is suffering needs their story heard. This story is not in a computerised read out, it is in the soul that is suffering. Has this art been lost? Compassion and empathy that extend to healing do not exist in a test tube.