What does that young doctor mean on the TV series ER when he blurts out ‘We need a CBC, Chem 7 and lytes, LFT, drug screen, AP and Lat, swab and call the OR tell’em we’ll need a room STAT’? Answer: He is asking for blood and urine samples to be taken and sent to the laboratory for testing, ordering various X-rays, asking for an operating room to be prepared and raising next year’s health insurance premiums by 15 per cent. He is, however, also gleaning the information that he will potentially need to save a life.
Most investigations are warranted and are, without argument, modern medicine’s gift to health. Understanding the balance of certain minerals in the bloodstream tells us the state of the kidneys and liver, sugar levels tell us the state of the pancreas, the level of white blood cells tell us how the immune system is functioning – the list goes on. There are many sophisticated tests that an individual may only come across should they become unwell but a certain array of investigations may be used as a screening process and might even be encouraged to enable a healthcare practitioner to monitor the well-being of the patient. I list below some of the basic tests that may be of benefit or be mentioned to give the layperson a guideline to what information is being sought. The main problem with investigations is the concept of a ‘normal’ range of results. Normality is measured by testing a large number of people and drawing up a standard deviation curve.
What this means is that the top or bottom three per cent of any group are automatically considered too high or too low. This may not be the case and a result that suggests an abnormality may in fact be perfectly normal for the individual. Also, someone with a result within the ‘normal’ range may in fact be quite abnormal. For example, if a haemoglobin level of 11.5 is found, the orthodox world would say ‘normal’. But if that person should have a level of 15, then it is considerably lower than it should be and yet may not be treated.
There is no black or white in health. The orthodox medical world tends to lose sight of that grey area and may rely too heavily on results. Investigations should be integrated into a full clinical setting, story-taking and examination and not viewed on their own merits.