Remember the gizmo Bones, the doctor on the original Star Trek, held a few centimetres above a patient and it provided all pertinent information including a diagnosis? It’s high time modern medicine got to the same point.
This post is a pure ‘please do better’ to the medical system. We need medical diagnosis to catch up with the 21st century. Many current diagnostic tests seem the equivalent of those creepy cages and metal contraptions of medieval torture.
Here’s what’s set me off:
I saw this poster on a bus in rural Nova Scotia. I understand the motivation. Mammograms, used for screening, are documented to decrease death due to breast cancer¹. Being a responsible medical provider, the NS government is trying to convince people to undergo screening. But the test is demeaning, uncomfortable and with slight risks. They acknowledge the unpleasantness, but still encourage people to do it.
Why support the participation in something uncomfortable? Take a page out of any business marketing book – if you want people to embrace your product, make it appealing to them.
Mammograms are the tip of the medical-testing-draconian-torture iceberg. Another common medical test, supported as a life saver by various medical organizations, is the colonoscopy. Yuk. Begin 24 hours in advance with consumption of a disgusting drink and volumes of water, necessitating that you cling to the outskirts of a bathroom and feel like you ate several tins of browned beans for lunch. To add to the experience, the next day, when you’re feeling at your worse, a perfect stranger shoves a metal tube up your ass, then you feel light-headed and woozy for the next 12 hours. Demeaning, time-consuming and disgusting for the person who cleans the bathroom.
A colonoscopy isn’t that bad and it prevents death due to colon cancer². If you want to undergo a truly harrowing medical test, there’s imagining by MRI. I was prescribed one of these and on my way to the torture, sorry, I mean test, chamber, I looked into the eyes of the woman coming out. I saw fear. When I balked at the test, the technician suggested my doctor prescribe sedating drugs. When I recounted my experience, friends described their coping mechanisms. What else do we willing do that requires sedation, denial and putting ourselves through hell?
I could go on. The worst test I’ve heard of is a screen of lymph node that many cancer patients have. Everyone I know who’s had this test comes out of it in tears.
What are we subjecting ourselves to in the name of medicine?
Consider the basic human reactions that need to be over-ridden for many medical tests:
- consuming substances that your body wants to vomit
- enduring ‘discomfort” (either out-and-out pain or something invasive) that your instincts tell you to swat or punch away
- surrendering all control to a stranger
- doing things that involve side effects after or before the test including, but not limited to, headache, vomiting, diarrhea, constipation, nausea, dizziness, fatigue, muscle aches and feeling like you’ve been taken advantage of
- paying for the infliction of discomfort (either directly or through your taxes).
It’s nuts: Enduring degrading, painful, anti-intuitive nonsense, parading around mostly naked, abandoning your worldly possessions (when else do you put down your phone or take off your wedding ring?), spending your time in unpleasant, perhaps grave-like or otherwise confining surroundings. Have I said YUK enough?
Yes most medical tests are beneficial to patients, identifying conditions and facilitating appropriate treatment, reducing pain, suffering and mortality. But more forethought when developing the tests might allow for a more pleasant patient experience. Tech startups do this all time – consider the user experience. All businesses cater to their customers, because happy customers buy more.
The Tricorder, with the nirvana of completely non-invasive testing, isn’t here yet, but it’s a great goal to aim for.
To put a reality-based context to this, there was a contest announced by Qualcomm in 2011³ that invited contestants to develop a real-life Tricorder which detected Anemia, Atrial Fibrillation (AFib), Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Leukocytosis, Pneumonia, Otitis Media, Sleep Apnea, Urinary Tract Infection, and Absence of Condition(4). The device was also expected to give routine physiological measurements of heart rate, oxygen, blood pressure, temperature and respiration rate. I am totally enthusiastic about ‘Absence of condition’. To me, that is the single biggest gap in modern medicine – the ability to say ‘there’s nothing wrong with you’. I know there are liability issues here, but it’s probably what people most need to hear and doctors are most reluctant to say.
Let’s boldly go where no medical diagnosis has been before – to an ideal patient experience.
- This is a credible source which attempts to summarize the data: http://www.cancer.gov/types/breast/hp/breast-screening-pdq