Myth

I went to university campus for a meeting the other day, and happened to find a book Because I Said So!

It's hard to find a better mythbuster of old wives' tales than this book written by Ken Jennings. He quotes us countless old-timey examples of parental wisdom confidently passed down generations - and only found to be lies ("The car won't run unless your seat belts are on!") or dead wrong ("Don't sit on cold surfaces, or they'll freeze your gonads and wind up sterile," as kids are being told in Russia).

That's trivia reading, but serious enough with reality check and meticulous search of scientific evidence (or the lack thereof) behind the century-old lectures ("You need eight glasses of water every day!").

Do we have similar dogmas in medicine, similar to those because-I-said-so bluffs quoted by Ken Jennings? I have a sneaking suspicion that we do.

One of my recent duties is to go over the protocol in our dialysis unit. Yes. A very detailed mandate to guide doctors and nurses how frequent we should order this test and that test, how meticulous we should request annual chest x-ray for our patients. We have been following that piece of advice for twenty years, as precisely as kids are told not to swim within one hour of the last bite of lunch (Sixty minutes and one second: you'll be fine). But why? Why do the patients need chest x-ray when there is no complaint at all? But screen we must. Huh? Even after we'd been convinced to do something, the choice of chest x-ray leaves us befuddled. If CT scan sounds like full-frame digital camera, chest x-ray is a pinhole camera. In plain terms, chest x-ray is a primitive tool that tends to pick up noise rather than signal.

So a simple answer to the question is: Because I said so. The advice seems to simplify things and give our patients a safer window. Except, of course, when it complicates the matter.