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Different strokes

Half the population would recognise the signs of a stroke, says Copperfield. The other half haven't a clue

I've got nothing against the Stroke Association – I think they do great work. They popped up on BBC Breakfast telly recently to raise awareness about the provision (or to be more accurate, the patchy nature of the provision) of carotid artery imaging and endarterectomies for patients who've experienced a TIA.

And yes, I'll admit that GPs aren't always as pushy as we ought to be when it comes to the referral process.

One of the charity's most high-profile contributions has been the F.A.S.T. campaign, alerting people to the most common clinical presentations – facial weakness, upper limb weakness or dysphasia – and encouraging them to consult urgently if they notice them.

So what's not to like? Surveys have shown that before the campaign started only half the population would recognise the signs of a stroke in themselves or others. Experience has told me that the other fifty percent have some really weird ideas about what might and might not be cause for concern.

Going transiently blind in one eye? Absolutely. Slurring of speech without recent exposure to a couple of pints of Tactical Nuclear Penguin, the world's strongest beer? You betcha. A funny feeling down your leg after three hours playing Assasin's Creed 2 on your X-box 360? Nope. Really, no.

Ah, but mark well the words of the highly qualified TV presenter - words to the effect that 'we all know our own bodies'. All that guff about faces, arms and cerebral language centres? Nothing but a diversionary tactic to stop you demanding the urgent CT scan your transitorily numb bum so obviously merits.

People in general do not know their own bodies. Seminal research asking them to play along with 'pin the organ to the human' parlour games made that crystal clear as they cheerfully pinned images of the adrenal glands to the neck, kidneys to the thorax and cerebellums to the pudenda.

If you want to confirm this for yourself, next time somebody spins you the 'I know my own body' line ask them to run through the structure and function of the parathyroid glands, just for fun. As far as I'm concerned, 'I know my own body' is right up there with 'it works for me' and 'I know my rights'. Maybe it does and maybe you do – but don't expect that to influence my judgement in any way.

Unless they've actually witnessed an autopsy first hand - and I'll accept the logistical difficulty in that autopsy being their own, however much I might be keen to see it for myself - people are not allowed to say that they are big-boned, have weak chests or to claim preternatural self-awareness. This applies doubly to 'celebrities' whose pseudo-scientific ravings exert far too much influence over the health beliefs of their fans.

We're in a situation where the provision of stroke services to patients is so erratic that in some areas endarterectomies are delayed so long after a TIA that to perform them might actually be a riskier undertaking than to abandon the idea altogether. The last thing we need is for the system to be swamped by another lorry-load of the worried well.

'Sick Notes' by Dr Tony Copperfield is out now, available from Monday Books.

Copperfield Copperfield

          

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