Intended for healthcare professionals

Observations Out of Hours

Why medicine is overweight

BMJ 2010; 340 doi: (Published 02 June 2010) Cite this as: BMJ 2010;340:c2800
  1. Christopher Martyn, associate editor, BMJ
  1. cmartyn{at}

    Is it really admirable that doctors investigate more rather than less, and intervene with treatment early rather than late?

    Browsing in a second hand bookshop, you might not think that a volume with the title Structures would be worth pulling down from the shelf—unless your eye had been caught by the strap line “Or Why Things Don’t Fall Down,” which hints at both humour and an offbeat approach. In fact, J E Gordon’s book (Pelican Books, 1978) is a riveting introduction to the principles of engineering that, among other things, explains how medieval masons got gothic cathedrals to stay standing and why blackbirds find it as much of a struggle to pull short worms out of a lawn as long ones.

    Among the book’s quirky insights, there’s an account of why most fabricated things turn out heavier than the designer intended. The main reason is psychological: everyone involved in construction has a tendency to play it safe by making each part just a tad thicker and heavier than required. On the face of it, this seems admirable—a sign of honesty and …

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