When a famous person dies, doctors cannot help themselves: Get a CAC scan, Echo, BP check, eat fatty fish, and more
What interventions save lives?
When a famous person dies— be it a celebrity or political figure— near instantly, we learn online what we should do to avoid the same fate.
Today, I learned, that we should all get a:
a regular visit with your doctor
When a famous young film actor died of colon cancer in his 40s, the medical establishment changed colon cancer screening to start at age 45 (not 50). Some said we should begin even earlier: perhaps 40 or 35 or 30.
It is the most natural thing that after some thing bad happens, our instinctive reaction is ask what can we do to avoid it.
Don’t go on cruise ships (Well that one is good advice ;).
Of course, when it comes to flying in to Reagan or eating at Chipotle— it is easy for people to use their common sense. Of course, Reagan is a busy airport and I am happy to concede the risk of a crash is higher there than Dulles, but goddamn that Dulles traffic is bad. You know what.. I will take the risk to save 90 mins.
And of course, Chipotle has been in a rough spot, but they have cleaned up their entire supply lines, and their food is actually real food and not ultra-processed garbage (other fast food) maybe it is time to return.
But when it comes to medical advice, it is hard to be critical. To stop for a minute and ask if the recommendation is sound.
What happens if everyone gets a CAC scan?
What happens if everyone gets an echo?
Does seeing a doctor regularly improve outcomes?
Should I eat more fatty fish?
I won’t bore you with meta-analyses and systematic reviews, and a sea of confounded observational studies, but it is fair to say the evidence for all of these claims is nonexistent to weak.
If you are having tearing chest pain, then yes, please go to the emergency room, and before they push heparin, perhaps they should rule out dissection, but if you are a 68 year old watching the news, and otherwise feel fine, should you get a :
CAC scan - there is no evidence you will live longer
Echo - no evidence you will live longer
See a doctor regularly (you should check your BP (you can do it anywhere), but there is no evidence routine health visits help beyond this.)
Should you eat more fatty fish? There is absolutely no good evidence for this.
And should you get a colonscopy at 45?
Actually, you should have gotten it at time of birth; 14 at the latest.
I don’t fault lay people for trying to understand a medical tragedy by finding something to grab on to— some intervention they can make in their own life to escape their own fear of mortality— but it is problematic to see doctors leap to unfounded conclusions.
It is always tragic when anyone dies suddenly, and it is natural to try to make sense of it, but sometimes a person can get good medical care, excellent medical care, have well controlled hypertension, and still die of dissection. And if you prescribed echos for all people who fit that description, you will do far more harm than good. That’s the hard truth about life: we all die, and technology is not always able to save us. Even if we used it daily and sync it to our watch.