This is an example of how our health system is getting more and more
ridiculous. Why should a presumably healthy woman have *any* lab tests done,
aside, I suppose from some screening tests which have some proven value (I
won't go into the question of routine mammograms)?

So here we have a presumably healthy person who has a high alkaline
phosphatase and the panic begins. So we are set to do a bone scan!! And she
is nursing, so they will tell her to stop breastfeeding for a while, and the
child and mother will be miserable.

An orthopedic surgeon at the Hospital for Sick Children has described,
tongue in cheek, what he calls the Ulysses Syndrome, of which this is a
perfect example. A test is done as a routine, and a result returns which is
"abnormal".  There then begins a long voyage of searching for the cause. It
goes on and on and on, and eventually nothing is found.

If anyone remembers the movie The Hospital, with George C. Scott (not bad
for the first half, then deteriorates into nonsense).  One of the first
scenes shows the staff physician Scott, being talked to by the resident who
has taken him aside. To paraphrase "So this guy goes for a routine insurance
physical. He's healthy. They find some protein in his urine. They do a whole
bunch of tests and nothing. So they book him for a kidney biopsy, which he
has. He bleeds, goes into shock, and now he's in coma in that bed in kidney
failure". It's funny because it's so ridiculous but it's also tragic,
because such things have actually happened.

Jack Newman, MD, FRCPC

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