McCoy's syndrome: a new medical entity

Abstract

1 The Lancet. Torture in Syria’s hospitals. Lancet 2011; 378: 1606. 2 Human Rights Watch. Syria: Red Crescent workers under attack. http://www.hrw.org/ news/2011/09/14/syria-red-crescent-workersunder-attack (accessed Nov 12, 2011). 3 Anon. Bahrain protests: trial opens for 47 doctors and nurses. BBC News Online June 6, 2011. http://www.bbc.co.uk/news/worldmiddle-east-13673299 (accessed Nov 12, 2011). 4 Shah S. CIA organised fake vaccination drive to get Osama bin Laden’s family DNA. The Guardian July 11, 2011 (accessed Nov 13, 2011). 5 United Nations Offi ce of the High Commissioner for Human Rights. Individual complaints. http://www.ohchr.org/EN/Issues/ Health/Pages/IndividualComplaints.aspx (accessed Nov 13, 2011). One of us had experienced a clinical situation like this before, and Abraham Verghese speaks about a similar case in one of his talks. This set of missed diagnoses illustrates a condition that we propose to name McCoy’s syndrome. Leonard McCoy is a science fi ction character—the doctor of the starship Enterprise in the original Star Trek television series. The story takes place in the 23rd century, where he uses a “medical tricorder” with a hand-held sensor to examine patients. This apparatus lets him make precise diagnoses, without the need to interview and examine patients in the traditional way. Unfortunately, McCoy’s syndrome seems to be widespread in the health system at the moment, striking mainly doctors, but also other healthcare professionals and even patients. The most characteristic feature of the syndrome is the excessive faith in medical technology, particularly imaging. Other components that might also be present are the absence of clinical reasoning and of establishing emotional links with sick people. Some cases also show incapacity to think about common diagnostic hypotheses, particularly in university hospital environments. Medical tricorders, unfortunately, are not a reality yet. The careful physical examination of patients and history taking, although depreciated, is still the cornerstone of precise diagnostics. We cannot deny the huge value of technological advances that have been seen in the medical fi eld during recent decades. But we must use them wisely and with parsimony, and not ignore the simple, basic procedures that depend only on our own vision and sense of touch.