January 26, 2007

IT'S NOT ABOUT HEALTH, JUST ATTENTION-SEEKING:

Should You Have a Physical? (Steve Gordon, 1/26/07, Valley News)

An editorial in a medical journal a few years ago posed this scenario to physicians: An apparently healthy 45-year-old woman comes to you requesting a physical. She has no medical problems, and her cholesterol was fine when last checked two years ago. You ask her a range of questions about her life and lifestyle: about depression, for instance, and smoking and alcohol use. No red flags emerge.

"Your assistant" the editorial continues, "has recorded the patient's blood pressure (normal) and weight (10 pounds above ideal). You examine the patient's breasts and pelvis while counseling her to lose 10 pounds, wear seatbelts, take calcium and visit a dentist regularly. As you leave the room, you tell her to come back in three years unless (her Pap) smear is abnormal or she experiences new symptoms of concern.

"Would this patient feel well-cared for?

"Probably not."

What, no blood test? No X-rays? No rectal exam? No chilly stethoscope on the chest or back?

The routine physical, often done annually, was once a staple of every general medical practice. Over the years, it has included blood tests, listening to the lungs, looking into the eyes and ears, checking blood pressure, testing reflexes, even taking chest X-rays, among other things. It had a cookie-cutter quality: Pretty much everyone got pretty much the same thing.

Today, though, the routine physical exam is a discredited anachronism.

Well, sort of.

Major medical organizations such as the American Medical Association have been saying for more than 20 years that physicals have no clinical value that justifies the time and resources involved. In other words, they haven't been shown to catch or prevent serious illness or lengthen patients' lives.

But, as surveys and studies consistently find, patients still want them.


No straight male has ever wanted one.

Posted by Orrin Judd at January 26, 2007 1:59 PM
Comments

Brothers poll: which among you would prefer to risk getting colon cancer rather than submit to a colonoscopy every 12 months (or even once)?

I am raising my hand. That's 1.

Posted by: Bill at January 26, 2007 2:32 PM

A friend just died of colon cancer because he was just as macho as you guys and colonoscopies are painless.

This is silly. Tests are available that will catch cancers at an early stage, how can that not help save lives?

Posted by: erp at January 26, 2007 2:37 PM

Because if you catch them at an early stage they aren't cancers.

Posted by: oj at January 26, 2007 3:12 PM

If you have one every twelve months you don't meet the tagline qualification.

Posted by: oj at January 26, 2007 3:12 PM

My goal is to avoid entanglements with the Medical-Industrial Complex for as long as possible.

Posted by: Raoul Ortega at January 26, 2007 3:23 PM

My lower back has been screaming like crazy all week. Everyone tells me to go to the doctor, so I go. The doctor says, "Lose that big potbelly, take some ibuprofen as needed, use a heating pad and do these stretches."
Shoot, I knew all that already and I just lost 150 bucks from my HSA!
Of course, I'm not old enough to require a yearly colonoscopy - I just hope I'm not as big a crybaby as Orrin is when I do. Lie back and think of Patton!

Posted by: Bryan at January 26, 2007 3:47 PM

Buncha [si]ssies.

Posted by: ghostcat at January 26, 2007 4:52 PM

If you went to a doctor without a wife making you then you don't meet the criteria either.

Posted by: oj at January 26, 2007 4:56 PM

"Making" me? Making me? How dare you, sir?

(You either just redefined free will or moved the goalposts.)

Posted by: ghostcat at January 26, 2007 5:23 PM

Not just the colon, men of a certain age should have regular prostate exams.

Only a fool would think otherwise.

Only an evil fool would try to make a lame joke about a serious health subject.

Posted by: dna at January 26, 2007 5:33 PM

dba -

Dude's married to an MD. Like a Chris Rock routine.

Posted by: ghostcat at January 26, 2007 5:38 PM

to the contrary, only a fool believes in testing:

dartmed.dartmouth.edu/summer05/html/hunting.php

Fools aren't evil though, no matter how far up their own colons they cram their heads...

Posted by: oj at January 26, 2007 6:14 PM

Men don't have free will vis-a-vis their wives. That's the great miscalculation that feminists made too.

Posted by: oj at January 26, 2007 6:19 PM

I'd go to the doctor more often, but there's always to damn many sick people there, that I'm afraid I'll catch something.

Posted by: AllenS at January 26, 2007 6:19 PM

AllenS -

The irony detector spots the influence of both Groucho and Yogi in that comment.

Posted by: ghostcat at January 26, 2007 9:36 PM

ghostcat - you ever watch someone die of cancer? I have.

There are some things that are not funny, cancer is one of them.

Besides, isn't it rather pathetic that a man his age indulges in frat boy humor? Maybe if he ever gets colon or prostate cancer he can personally experience just how humorous it is.

Then we can all have a good belly laugh.

Posted by: dna at January 27, 2007 6:49 AM

dna:

In 1999, I took my girl friend out of the hospital and took care of her for three months while she died of a glioblastoma multiforme cancer. Either grow up, or find some place else to play. I'd be willing to bet, that most of us have experienced far more about life, than you have.

Posted by: AllenS at January 27, 2007 7:30 AM

Allen - and you find that funny?

How wonderfully Christian of you.

Posted by: dna at January 27, 2007 8:00 AM

One more time, grow up. Where do you find funny in what I said? Reach around, and pull your shorts out of your *ss.

Posted by: AllenS at January 27, 2007 8:07 AM

You need to improve your reading skills. Its your finding OJ funny and defending his humor that is objectionable - and very unChristian.

As for growing up, I'm in my late 40s. As such I can remember the humor of Foster Brooks whose shtick was bascially to be pretend he was drunk as he slurred out words. Seems America has grown up and decided that drunk humor is no longer funny, since it leads to ruined lives and tragic deaths in car accidents.

I'm certainly old enough to remember Cheech and Chong and their drug humor. Seems America has grown up and drug humor has gone out of fashion as well due to deaths and ruined lives from drugs.

In short there are topics that no one with any decency (certainly no Christian) should ever find funny - or defend.

Now I would venture an opinion that anyone who finds cancer funny is in desparate need of growing up, not the other way around. So when you decide to grow up and join the rest of America we'll be happy to have you.

BTW It was my father who I first watched die of cancer. Did you get a chuckle out of the nausea from chemo? Did you chortle over the constant pain and fear? I hope not, because that would make you as despicable as OJ.

Posted by: dna at January 27, 2007 9:15 AM

Bingo! The liberal believes that life is too tragic to enjoy. That's why you're all so miserable.

Our mortality doesn't upset the Right.

But the question here isn't your humorlessness but your complete ignorance of the efficacy of medical testing.

Knowing someone with cancer doesn't actually give you any special insight anymore than you need to have been a soldier to speak about Iraq. Indeed, subjectivity precludes insight.

No wonder people think I make you guys up.

Posted by: oj at January 27, 2007 9:32 AM

cruel = conservative?

Posted by: dna at January 27, 2007 9:37 AM

dna:

If it's within reach, please move the Doomsday Clock forward a couple of minutes.

Posted by: AllenS at January 27, 2007 9:57 AM

Allen:

He can move the hands of the clock as much as he wants (spin it like a top, even); we just don't want him to be able to actually push the button.

OJ: don't ever get a urinary tract infection. The doctors won't leave your prostate alone. Of course, if your GP has a goatee and a Scottish brough, then have at it.

Posted by: ratbert at January 27, 2007 10:25 AM

rat:

I passed a kidney stone when I was a little kid and it was so unusual they didn't believe that's what it was so the docs and nurses probed every orifice known to man repeatedly. It was like Shawshank, but without Redemption.

Posted by: oj at January 27, 2007 10:52 AM

dna:

Precisely. Conservatives accept Creation and laugh at cruelty. Liberals are unable to and sob.

Posted by: oj at January 27, 2007 11:05 AM

cruel = Christian?

Posted by: dna at January 27, 2007 11:57 AM

Absolutely. If you don't think the Book of Job is hilarious then you want socialized medicine.

Posted by: oj at January 27, 2007 3:09 PM

So to be a conservative means that you laugh at other people's pain and suffering. Do you laugh in their faces or just chuckle to yourself in the quiet of your private thoughts?

What exactly is funny in Job? Please explain the joke to me.

You know I've seen your picture at Pajamamedia Sparky and I got to tell you, forget about the colon and prostate, the obesity alone will kill you sooner rather than later. So by all means, avoid the doctor. You'll get to stand before God all the sooner.

And then you can explain the joke to Him.


Posted by: dna at January 27, 2007 5:35 PM

Allen,

Doomsday clock?

Posted by: dna at January 27, 2007 5:36 PM

If God didn't find us amusing we wouldn't be here. It's only liberals who don't think life is funny, which is why they hate God.

Posted by: oj at January 27, 2007 5:43 PM

Gee I thought if God didn't LOVE us we wouldn't be here.

Some parts of life are funny, even joyous, others not so much. Its an immature and sophomoric mind that can't see the nuances. The kind of mind that thinks frat boy humor is funny.

Why would anyone hate God?

So what is the joke in Job?

Posted by: dna at January 27, 2007 5:50 PM

The biggest joke is on Satan, and the lesser joke is on the three comforters, each of whom thinks he knows the whole story. Today, we look at Job with wonder, after each of the four messengers delivered his news - all within about a minute or two. We can imagine one moment of bad news, but this was a cosmic avalanche.

Of course, God's pointed (and overwhelming) questions are funny, too. After all, the answer is obvious, even to Job, who repents. But he saw the Almighty in the whirlwind, not something that happens everyday. I would not say the 'joke' was on Job (that would be cruel and foolish and wrong), but God was certainly not tame with him, now was he?

Posted by: jim hamlen at January 27, 2007 7:22 PM

"Why would anyone hate God?"

Now there's a thread for you.

The short answer is that he is God and we are not.

The long answer is that he is holy and we are not. And we don't like being told we have to be.

Posted by: jim hamlen at January 27, 2007 7:26 PM

Creation is as God made it, not as you'd make it, that's why you hate Him. The self uber alles.

Posted by: oj at January 27, 2007 9:58 PM

Jim,

Job is about why good people suffer, people who don't deserve to suffer. Your right, both Satan and Job's Comforters end up looking bad but for more subtle reasons than you state.

When contemplating why evil exists in a world made by a benign deity, it helps to remember that God is not a behaviorist.

Evil comes in two flavors, physical evil (hurricanes, plagues, earthquakes, disease, old age, etc.) and moral evil (murder, theft, abuse, hatred, etc.). The first deals with the fact that the universe is often a painful and unjust place where the innocent suffer. The second deals with the evil committed by less than perfect humans on their fellows.

Moral evil is relatively easy to answer: God gave us free will to chose either good or evil. God did not wish to create a race of mindless, puppet automatons lacking the ability to chose. For all the evil done by man throughout history, our current situation is preferable to being a mindless slave. Those who would prefer otherwise in effect want to be slaves.

Furthermore, love isn't love unless it is freely given. For God to force us either by design or will to love Him always would result in the making love meaningless. God is not a rapist. As the Good Book says, "God is Love". The ability to chose evil (and all the resultant pain and suffering caused by men) was given to us for the sake of love. Do we pay too high a price for love? I honestly don't know. But the other alternative (quoting thought policeman O'brien in "1984") would be "God is Power". He could stop the gulags, concentration camps, etc. only by making the whole universe itself a concentration camp -- with Himself as commandant.

God chose love instead of power, because a perfect world was to horrible to contemplate.

Physical evil is a bit trickier to address. Why do good and innocent people suffer? Why is suffering even possible? To make pain and suffering impossible, the universe would have to be perfect -- and frozen in its own perfection. Since any change would mar its inherent perfection, such a universe would be a dead place without change and growth. Perfection = completion = death. It would be a dead place devoid of life. If moral evil is the price we pay for freedom and love, than physical evil is the price we pay for life.

There is a story that God created a perfect universe before He made our own. Not liking the results -- a place of eternal death -- he cast it aside and began work on the deliberately imperfect universe we live in. The first universe still exists. It's called Hell.

But why do the innocent suffer and why do evil people prosper? Well this brings us back to free will. Even if the potential for free will existed, it wouldn't mean much if the universe had a built-in system of rewards and punishments designed to coerce behavior. So does anyone wish that God was a Tyrant, using the physical universe as a system of rewards and punishments, and humanity reduced to the level of pigeons inside of a BF Skinner box? And so we have a world where innocent children die or are born handicapped, people through no fault of their own suffer the pains of living, and evil people often live happy lives of material contentment. But it beats the alternative. As I said at the start, God is not a behaviorist.

If God is not a behaviorist, the Devil most certainly is. This is apparent from the opening scene in Job where Satan bets God that Job is only good because he has been physically and materially rewarded. And that's the whole point of the story, whether we should be good no matter what or be good only if things are well. God's answer is as obvious as it is harsh. For those who would wish that God was a behaviorist, coercing them and making slaves of them, God has this to say, "Gird your loins like a man."

What he does not do is sit back and laugh at other people's sufferings like OJ. Unlike OJ, God is not cruel.

Posted by: dna at January 28, 2007 6:39 AM

OJ, see my response to Jim. I wouldn't have the universe any other way than how God made it.

It appears that His goal was not the most perfect world but the most free. As such we stand delicately balanced between chaos (where freedom becomes meaningless) and perfection (where freedom is not possible).

Posted by: dna at January 28, 2007 6:43 AM

I don't remember having two angry trolls (can't count macduff, he's polite) commenting at the same time. Double the fun.

Posted by: erp at January 28, 2007 9:17 AM
« IT'S ONLY IN THE MIDDLE EAST THAT WE DENY MAJORITIES SIMILAR DEALS: | Main | NORMING PATHOLOGY: »