Today Janet went to the Eye Clinic, referred by an over-anxious optician who at a purely routine eye test was unhappy about the appearance of the back of Janet’s eyes, in particular the “optic disc”. The anxiety engendered by this action was almost incalculable, since both Janet and I were well aware that a secondary tumour in the brain was at least a theoretical possibility, and that if present it could appear as a blurring of the optic disc. So it was enormously reassuring to be told emphatically that the appearance of the back of the eyes was normal, as were all the other tests the ophthalmologists had done (including the visual fields, also a potential marker of a brain tumour).

This episode illustrates the adverse impact of “doing tests” without good enough reason, in this case referring to a specialist. Tests and referrals in general are prone to induce “somatisation”, the belief that something physical must be wrong, and in some circumstances generate severe anxiety that something specific must be wrong. Both are harmful.

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