We all think we’re going to die

If a plane should crash and the passengers all survive, some of them will tell you that when they got on the plane they ‘knew’ it was going to crash and the media will portray them as clairvoyants. What they probably won’t consider is that every time a plane takes off, a few nervous passengers are thinking that it might crash (while they wash down a valium with a gin and tonic).

Every day I see three or four patients whose gut feeling tells them that their symptoms are due to cancer.¹ I see three of four new cases of cancer a year. One or two of those who have cancer might have suspected cancer when their symptoms began, and were eventually proved right. Often people are diagnosed with cancer who weren’t suspecting it at all.

Of course we should listen to patients’ concerns, interpretations, fears, and so on. And of course we could do better. But if we are to be clinicians, then we need to put what we hear into context and use our clinical judgement.

If we overstate the importance of gut feeling, we will refer unnecessarily, wasting patient and clinician time, and money. And those whose guts are less feeling, but do have cancer, will suffer.

• © British Journal of General Practice 2017