What will happen if I do nothing? Most patients are conditioned to avoid asking that question after a self-assured physician reports the result of a test or investigative procedure that uncovers evidence of a scary disease. And the widely revered mantra “early detection saves lives” further impedes any impulse to challenge medical expertise. After all, doctor knows best. 

Not always, concludes Alan Cassels, a well-known drug policy researcher at the University of Victoria. With engaging clarity backed by academic rigour, Cassels discusses a variety of popular investigational procedures – some of them, like mammograms and PSA tests, downright controversial – then proceeds to lay out all their associated hazards and limitations.

Cassels doesn’t slag doctors who seem to automatically order tests without meaningful patient consultation. Almost all are driven by a mix of compassion and scientific curiosity to identify and cure – to dig for the clinical answers behind symptoms that could signal a serious issue, even as they remain enthralled by the new gee-whiz diagnostic technology that’s ready to play Tonto to their Lone Ranger.

But Cassels reserves special respect for doctors who invest the time with a patient to disclose the pros and cons of every test or procedure, including the possibility of false positives (or negatives), as well as any potentially risky side effects that could add physical discomfort to deep personal anxiety. That’s the kind of care partnership that’s based on realistic expectations, no matter what the test results point to. It also acknowledges an implicit truth: buzzy tests like a whole-body scan will almost always reveal something amiss. The human body starts to fail and falter at age 30. Seek and ye shall find.

Despite the confident rhetoric of its practitioners, all modern medicine remains a crapshoot. No outcome is ever absolutely certain. Cassels’ advice is to assess the odds wisely before making an informed decision to undergo or decline any test or proposed remedy. Seeking Sickness is an excellent way to start the important process of self-education.