Coleman’s 2nd Law of Medicine: Tests are useless unless the Results will affect your Treatment
September 19, 2023 by Doctor Vernon Coleman
A few years ago I created 12 laws of medicine designed to help patients get the best out of doctors and hospitals.
Coleman’s Second Law of Medicine states that there is no point in having tests done unless the results will affect your treatment.
Now tests are, of course, often vital – essential to the making of an accurate diagnosis. But there are often risks attached when tests are done, and if tests are done which have no real value then there can be no upside – just the downside.
If your doctor wants you to have tests done ask him how the results will affect your treatment. If the results of the tests won’t affect the treatment you receive (and aren’t needed as a baseline against which to compare future tests) then the tests aren’t worth having.
Tests and investigations are often performed routinely, as a habit, and often performed in huge numbers. In private hospitals extra tests can result in huge profits for doctors, laboratories and the hospital.
Despite evidence to the contrary, tests are often regarded (by both doctors and patients) as being harmless. They aren’t.
There is no such thing as minor surgery (that’s Coleman’s 11th Law of Medicine) and even taking blood is an operation.
There are dangers inherent in every test that is performed. It used to be normal for all patients admitted to hospital to have routine chest X-rays – but this of course was extremely dangerous. X-rays can be carcinogenic and there is no doubt that routine X-rays have caused many cancers.
And there is, in addition, the danger that the result will be wrong and that your doctors will treat the test rather than treating you.
One of the problems with doctors doing too many tests and investigations is the fact that doctors often refuse to start treatment until they have received all the test results back. If they get test results within hours or days that is fine. But in some hospitals it can take months for test results to return.
Patients sometimes die untreated because doctors will not (or dare not) try treatments until all the investigations have been completed. The threat of litigation means that doctors insist on waiting for convincing evidence before trying anything. Inevitably, this means that it is not infrequently too late to act by the time treatment is started. If, for example, there are two or three possible diagnoses available and only one of the diseases can be treated then it would seem to me to make sense to start the treatment for the disease which can be treated, even though laboratory evidence in support of that diagnosis might not be available. But this isn’t what happens.
Doctors have a tendency to treat investigation results rather than patients. Don’t let them do this to you. When clinical observations and laboratory findings are incompatible, I think we should assume that the laboratory findings are wrong.
The important question to ask, when any test is being planned, is: will the results of this test affect my treatment?
If the answer is that the test won’t influence your treatment then what’s the point in doing the test? This brief summary of Coleman’s Second Law is adapted from Coleman’s Laws: The Twelve Medical Truths You Must Know to Survive by Vernon Coleman which is available on Amazon as a paperback and an eBook.
How IBS Can Affect Your Heart
14TH SEPTEMBER 2023 by Doctor Vernon Coleman
At six o’clock one evening a few years ago, I really thought my time was up.
I had spent a couple of hours working in the garden, I’d bathed, eaten and was slumped down in an easy chair with a cup of coffee and a good book.
Suddenly, I felt strange. I checked my pulse. My heart was going so fast I couldn’t begin to count it. I checked my blood pressure and pulse with a machine we have. My pulse was well over 150 and my blood pressure alternated between the absurdly high and the absurdly low. The machine lit up with all the little warning lights with which it is fitted. I had no chest, jaw or arm pain.
It was all my own fault.
I had been trying to ease my crippling IBS by taking acidophilus and by changing my diet, and, as a result, my symptoms had eased slightly. Stupidly, I had forgotten that IBS never goes away. Cockily, I had started eating rough, brown, wholemeal bread packed with seeds. It was wonderful to taste good bread again, after years of eating nothing but white bread.
The day before I had eaten four slices of wonderful, rough bread and now I was paying the price. Who would have thought that a few slices of rather tasty bread could cause such awful disruption.
My wife, Antoinette, wanted to call an ambulance but I wouldn’t let her. I felt certain that my crazy heart antics were a result of the massive amount of wind that was in my intestines in general and my stomach in particular.
The stomach and the heart share a common nerve supply (the vagus nerve or tenth cranial nerve) but although doctors recognise that burping may, rarely, be a sign of cardiac dysfunction they do not recognise that cardiac dysfunction (including palpitations, fibrillations and so on) can be a result of intestinal wind pressing on the nerve.
It took about six hours for my heart to start beating normally again. I was exhausted, inevitably, and yawning frequently too. (The vagus nerve also triggers yawning.) To the orthodox professional, yawning is a sign that a patient is having a heart attack but it can also be a sign of too much wind. Oh, and the vagus nerve can cause pains in the left arm too.
How many people, I wonder, are being treated for heart disease when their initial signs and symptoms were caused by wind? A million? Probably more. How many are taking potentially lethal anticoagulants such as warfarin which they do not really need?
And how many patients (let alone doctors) know that all the drugs used to treat irregular heartbeats have potentially alarming side effects – including irregular heartbeats. Oh, and that ultimate side effect known as death.
It is, I’m pleased to say, now more widely recognised that wind or gas in the stomach and intestines can cause palpitations. The wind presses on the vagus nerve and causes it to skip beats and then, sometimes, for palpitations to develop.
(It is, of course, essential that anyone who develops palpitations, or any other heart symptoms, see a doctor before assuming that the problem is caused by irritable bowel syndrome.)
Taken from Relief from IBS (Revised Edition) by Vernon Coleman – available via the bookshop on this website.
How to Survive the Future
15TH SEPTEMBER 2023 by Dr. Vernon Coleman
Whatever happens, the future is going to be very different. It has been clear for some time that the world is running out of oil and, as a result, our lives are going to change. Here are my notes (first published in 2007) describing how we can best deal with a different world. I was not writing then about the Great Reset – but about the problems we will face as the oil supply diminishes over coming decades. The climate change fraud (and the associated 15 minute cities and clampdown on travel) was created to force us to stop using oil. It is the coming shortage of oil supplies, not climate change, which politicians would be discussing if they were honest. My book A Bigger Problem than Climate Change explains everything you need to know about the oil shortage.
Prepare yourself mentally for a different world. A world in which the rich ride horses, the middle classes use bicycles and the poor walk everywhere they want to go. Think carefully about your current lifestyle. And try to imagine how difficult (and different) things will be when there is no oil.
Energy prices are going to rise inexorably. Take time now to reduce the amount of energy you use. Cut out all non-essential energy usage. Within the home the greatest expenditure is usually heating. See how low you can turn down your thermostat and still survive comfortably. Wear a sweater indoors and you may be able to cope with a lower temperature.
If possible you should acquire alternative forms of heating and cooking. Do not rely on one energy source. If you have gas central heating then you should have one or two electric heaters available. If you have to replace your oven consider purchasing one which will enable you to cook with either gas or electricity.
If you can become at least partly independent by installing an alternative personal energy source then now is the time to do it. Maybe a small windmill will supply at least part of your electricity needs. If you have a working but unused fireplace in your home then have the chimney swept and cleared so you can have log or coal fires to keep warm. Start laying down stocks of logs and coal. These things won't rot and I don't think there's much chance that they are going to go down in price.
Look around your home and make a list of all the gadgetry and equipment upon which you are dependent. How will cope without each item? Can you accumulate spares? Can you learn how to repair any of these items?
Prepare yourself for electricity blackouts by buying lamps and candles. Don't forget that you will need candle holders and matches. (And make sure that everyone in the family knows how to use them safely.)
If you are considering changing your motor car you might consider choosing a car which uses less fuel. Look also for a vehicle which has a decent tank capacity so that you can continue to make small journeys when there are fuel shortages. Reconsider all your travel needs. How much do you need a car of your own? Would you be able to cope more economically (and with less hassle) if you simply relied on taxis and hire cars occasionally? How big a car do you really need? Must you buy a new car? An older car may need more maintenance but the maintenance will almost certainly be easier to manage than a car which is controlled by a series of complicated computers. If you don't have a bicycle this would be a good time to purchase one. If you can't ride one then now is the time to learn. Folding bicycles are easy to fit into a car and it should be possible to carry them onto public transport. Equip your bicycle with panniers and a basket so that you can carry shopping on it.
If you are choosing a new home consider your likely future needs. Houses within walking or cycling distance of a railway station will sell at a premium in the future. A home that has its own water supply will be particularly attractive as public water supplies come under threat. But look for a spring or gravity fed supply rather than a bore hole. In order to get water out of a bore hole you will need an electric pump - and when the electricity goes off you will get no water.
If you have land consider establishing a vegetable garden where you can grow at least some of your own food. Try to grow as much food as you can. If you have little or no experience of gardening it will probably take you a year or two to learn some basic gardening skills. Acquire a small library of relevant gardening books. Try to manage your garden without using artificial fertilisers, pesticides, herbicides or other chemicals. Even if you don't want to start your own vegetable garden straight away you should, perhaps, start thinking of living in a home where a vegetable patch would be possible. (And, ideally, you should have a vegetable patch which is not open to the world. Thieves of the future will not be stealing television sets and mobile phones. They will be stealing potatoes and runner beans. If you grow your own vegetables you will have to be prepared to protect them from thieves. You should prepare now by making your house formidable, impenetrable and uninviting. If you need to dig up your front lawn in order to grow more food, you will need to think about ways to protect your crops from thieves.)
Do not take on any additional debt. Try to pay off any existing debts as soon as you can. Credit card debts are particularly expensive and can be a huge drain on your personal resources. If interest rates soar your repayments could be crippling. Water and food are, like fuel, going to become extremely expensive. And the coming price rises in oil and food will be structural not cyclical. Oil and food will never again be as plentiful or as cheap as they are now. Your savings could help you survive.
This could be a good time to examine your life. How many of the things you spend money on are essential to your health and happiness? How many of the things you buy turn out to be a burden rather than an asset? Every time you make a big purchase consider not just the cash price but also the time price. How many hours did you have to work to earn the money to pay for it? If you are contemplating buying an electrical item that costs £500 and you earn £5 an hour net of taxes then the item you're thinking of buying will cost 100 hours of your life. Step off the consumer treadmill and you may feel physical and mental benefits.
Try to replace some of the more complex tools in your house with simpler tools that don't need electricity. For example, a small hand drill may be slower and harder to use than an electric drill but you will still be able to use it when there is no electricity. Accumulate simple well-made hand tools to use around the house and garden.
This might be a time to start learning simple, practical skills so that you will be able to look after your home and your belongings without always being reliant on outside ‘experts'. Learning basic carpentry and basic plumbing will provide you with considerable freedom.
In recent years it has become increasingly difficult to obtain the services of a general practitioner out of hours. This is likely to continue (if not to get worse). Hospitals are likely to deteriorate still further as they struggle to cope with a top heavy bureaucracy, an increasingly incompetent and unhappy workforce and an on-going energy crisis. You should, therefore, make sure that you acquire some simple medical skills. Put together a simple first aid kit and a small library of easy to understand medical books.
Try to do as much shopping as you can at local stores and local markets. When buying food try to buy locally grown food. Big supermarkets may sometimes (but not always) be cheaper and it is certainly more convenient (if rather soul destroying) to do all your shopping in one store but when oil becomes increasingly expensive the big stores will not survive. (Transporting food and other supplies to their stores will be costly and many of their customers will no longer have the transport available for them to visit out of town stores.) If you and your neighbours do not keep small shops and markets alive where will you shop when the supermarkets close down?
Try to limit the amount of rubbish you accumulate. As oil become increasingly expensive, and local councils struggle to cope with their dramatically increasing pension obligations, so local services will deteriorate considerably. Rubbish collections, already threatened, will be non-existent. Try to free your home of as much rubbish as you can now. And be cautious about taking home new rubbish and clutter. You will need to find new ways to get rid of your rubbish in the future - either by burying it or burning it.
If you live in an area which is likely to flood then think about permanently moving your most valuable possessions upstairs.
Epilogue
When the oil runs out (which it will do soon) I believe that the world will change for ever.
Is there a chance that none of this will happen?
Yes, of course there is.
Someone may discover another entirely `free' form of energy: a form of energy we can use to drive motorcars and aeroplanes and from which we can obtain electricity.
Or maybe explorers will discover a huge oil field four miles underneath Milton Keynes.
Perhaps a young scientist in Latvia will perfect a perpetual motion machine.
Who knows, perhaps someone will find a way to turn sea water into oil.
Anything is possible.
If you think any of these scenarios are likely (and you're happy to put your trust in chance and good fortune) then you have no need to worry.
Otherwise, I think you should take this danger very seriously.
As I wrote at the beginning of this book, the problem of the disappearing oil is a threat to our civilisation much greater than global warming or terrorism. It is a threat which everyone in power knows about but everyone in power steadfastly ignores. It's a danger no one talks about.