Does every complaint need a test?

This news about Sheryl Crow having a meningioma was interesting to me as it seemed that she got an brain MRI as she was concerned about her memory..forgetting lyrics of songs as she has been reported to do quite often. This bring me to the question of whether it is right for people to ask for procedures, studies if they are worried about some symptoms. In my practice, often people will come in worried that they are getting demented or they have a tumor. I will do a detailed neurological examination and do a memory assessment ( SLUMS as MMSE is out of circulation due to copyright issues..but that's another story) and often they do not have any serious health concerns. I take the opportunity to go through their vascular risk factors like smoking, hypertension,diabetes, high cholesterol, sedentary lifestyle because often these can lead to vascular dementia. What is needed in case of concerns regarding memory loss, is to make sure treatable causes like hypothyroidism, vitamin B12 deficiency are looked for, risk for vascular disease is assessed- imaging is usually unnecessary.

Everyday Medicine

Medicine is so all-consuming-inspite of a family to manage and chores that are constantly multiplying-it always seems like the motor is always running. Walking down the corridor in the library, is a stroke a cause of the man's limp. I try not to stare but I am sure I do. I think about patients especially the ones when I think I could have done better. So, here I will ramble on about my experiences in doctoring. Hopefully,apart from an exercise in mindfulness it will reflect my journey as primary care doctor.